Intraventricular Hemorrhage | Children's Hospital of Philadelphia

What are the different grades of intraventricular hemorrhage? The amount of bleeding varies. IVH is often described in four grades: Grade 1. Bleeding occurs ... Skiptocontent   IntraventricularHemorrhage 1-800-TRY-CHOP 1-800-879-2467 Whatisintraventricularhemorrhage(IVH)? Intraventricularhemorrhage(IVH)isbleedinginsideoraroundtheventricles,thespacesinthebraincontainingthecerebralspinalfluid. Intraventricularmeanswithintheventricles Hemorrhagemeansexcessivebleeding Intraventricularhemorrhageismostcommoninprematurebabies,especiallyverylowbirthweightbabiesweighinglessthan1,500grams(3pounds,5ounces). Whatcausesintraventricularhemorrhage? ItisnotclearwhyIVHoccurs.Bleedingcanoccurbecausebloodvesselsinaprematurebaby'sbrainareveryfragileandimmatureandeasilyrupture.Babieswithrespiratoryproblems,suchashyalinemembranedisease,orothercomplicationsofprematurity,aremorelikelytohaveIVH.Thesmallerandmoreprematurethebaby,themorelikelyIVHwilloccur.NearlyallIVHoccurswithinthefirst fourdaysoflife. Whyisintraventricularhemorrhageaconcern? Bleedinginthebraincanputpressureonthenervecellsanddamagethem.Severedamagetocellscanleadtobraininjury. Whatarethedifferentgradesofintraventricularhemorrhage? Theamountofbleedingvaries.IVHisoftendescribedinfourgrades: Grade1.Bleedingoccursjustinasmallareaoftheventricles. Grade2.Bleedingalsooccursinsidetheventricles. Grade3.Ventriclesareenlargedbytheblood. Grade4.Bleedingintothebraintissuesaroundtheventricles. Grades1and2aremostcommon,andoftentherearenofurthercomplications.Grades3and4arethemostseriousandmayresultinlong-termbraininjurytothebaby.Hydrocephalus(toomuchcerebralspinalfluidinthebrain)maydevelopaftersevereIVH. Whatarethesymptomsofintraventricularhemorrhage? Thefollowingarethemostcommonsymptomsofintraventricularhemorrhage(IVH).However,eachbabymayexperiencesymptomsdifferently.Symptomsmayinclude: Apneaandbradycardia(stoppingbreathingandlowheartrate) Paleorbluecoloring(cyanosis) Weaksuck High-pitchedcry Seizures Swellingorbulgingofthefontanelles,the"softspots"betweenthebonesofthebaby'shead Anemia(lowbloodcount) ThesymptomsofIVHmayresembleotherconditionsormedicalproblems.Alwaysconsultyourbaby'sdoctorforadiagnosis. Howisintraventricularhemorrhagediagnosed? Inadditiontoacompletemedicalhistoryandaphysicalexamination,acranial(head)ultrasoundisusuallyusedtodiagnoseIVH.Thistestusessoundwavestocreateapictureofinternalstructures.Acranialultrasoundcanviewtheinsideofthebaby'sbrainthroughthefontanelles,thespacesbetweenthebonesofthebaby'shead.Withtheultrasound,theamountofbleedingcanbegraded. Treatmentforintraventricularhemorrhage ThereisnospecifictreatmentforIVH,excepttotreatanyotherhealthproblemsthatmayworsenthecondition.Althoughcareofsickandprematurebabieshasadvancedgreatly,itisnotpossibletopreventIVHfromoccurring.However,givingthemothercorticosteroidmedications beforedeliveryhasbeenshowntolowertheriskofIVHinthebaby.Thesesteroidsareoftengiventowomenbetween24and34weeksgestationwhoareatriskofearlydelivery.Sometimes,surgeryisnecessarytostabilizetheconditionofthebaby.Thismayoccasionallyinvolveplacementofacatheterintothebaby'sskull,althoughthisisrarelynecessaryinbabiesbecauseoftheflexibilityoftheirskullbones.   NextSteps ContactUs Children'sHospitalofPhiladelphia 1-800-TRY-CHOP 1-800-879-2467 1-800-TRY-CHOP 1-800-879-2467