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Intraventricular Hemorrhage (IVH)

Bleeding into the brain ventricles in premature infants can lead to neurological sequelae.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Intraventricular Hemorrhage (IVH)?

IVH is bleeding that begins with rupture of the fragile vascular structure called the germinal matrix, usually in infants <32 weeks and <1500 g. 80% of cases develop within the first 72 hours. Papile classification: Grade I (subependymal), Grade II (intraventricular, no dilation), Grade III (intraventricular, with dilation), Grade IV (parenchymal hemorrhage).

In pathophysiology, the immature vessel structure of the germinal matrix, fluctuations in cerebral blood flow, and coagulation disorders play a role. Antenatal steroid administration reduces risk.

Grade I-II generally have a good prognosis, while Grade III-IV are associated with hydrocephalus, cerebral palsy, and neuromotor delay. Screening is performed with early brain ultrasound.

Symptoms

Asymptomatic (small cases)
Sudden clinical deterioration
Apnea and bradycardia
Convulsion
Hypotonia and lethargy
Bulging fontanelle

Risk Factors

Prematurity (<32 weeks)
Birth asphyxia
Respiratory distress syndrome
Pneumothorax and hypoxia
Rapid volume infusion
Coagulopathy and thrombocytopenia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Routine neurological follow-up in NICU
  • Sudden apnea, bradycardia, or convulsion
  • When a drop in hemoglobin is noted
  • When a bulging fontanelle is present
  • For cranial ultrasound follow-up

Treatment Methods

01
Prevention with antenatal steroids
02
Minimal handling and hemodynamic stabilization
03
Monitoring with cranial ultrasound
04
Ventriculoperitoneal shunt if hydrocephalus develops
05
Serial lumbar punctures (temporary)
06
Neuromotor development follow-up and early intervention

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.