Intraventricular Hemorrhage of Infancy
Condition
(IVH; Subependymal Germinal Matrix Hemorrhage; Early-onset Germinal Matrix Hemorrhage; EGMH; Periventricular-Intraventricular Hemorrhage; PIVH)
Definition
Intraventricular hemorrhage (IVH) is bleeding into the spaces of a baby’s brain. It may cause harm to brain tissue and lead to long-term development problems.
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Causes
IVH is caused by the rupture of immature or fragile blood vessels in the brain. It is not known why this happens, but changes in blood pressure may play a role.
Risk Factors
IVH is most common in premature babies and those who have a low birth weight.
Symptoms
IVH often happens in the first 48 hours after birth. Most babies do not have symptoms. Those who do may have:
- Seizures
- Low muscle tone
- Muscle spasms
- Problems breathing, such as pauses in breathing
- Pedaling leg motions
- Changes is eye movement or alignment
- Pale or blue skin color
Diagnosis
The diagnosis is often made during a routine ultrasound in premature or low birth weight infants. Blood tests may be done to support the diagnosis.
Treatment
The goal of treatment is to stop bleeding and lower the chances of problems that may happen from it.
Procedures or surgery may needed to ease pressure in the brain:
- Ventriculoperitoneal shunt—a tube is inserted that runs under the skin and lets fluid drain from the ventricle (brain) to the belly
- Lumbar puncture, fontanelle tap, or surgery—to drain fluid from the baby's brain
Prevention
Women at risk of having a premature baby may be given medicine to lower the baby's risk of IVH.
American Academy of Neurology
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Caring for Kids—Canadian Pediatric Society
Health Canada
American Academy of Neurology
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Caring for Kids—Canadian Pediatric Society
Health Canada
References
- Intraventricular hemorrhage (IVH) in premature babies. About Kids Health—The Hospital for Sick Children website. Available at: http://www.aboutkidshealth.ca/Article?contentid=1774&language=English.
- Intraventricular hemorrhage of infancy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/intraventricular-hemorrhage-of-infancy-21.
- Intraventricular hemorrhage. Stanford Children's Health website. Available at: http://www.stanfordchildrens.org/en/topic/default?id=intraventricular-hemorrhage-90-P02608.
- Whitelaw, A. and Aquilina, K. Management of posthaemorrhagic ventricular dilatation. Archives of Disease in Childhood, Fetal Neonatal Edition, 2012; 97 (3): F229-F233.
Contributors
- Kari Kuenn, MD
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