Intraventricularl haemorrhage in the preterm infant

Intraventricular haemorrhage (IVH) characteristically initiates in the periventricular germinal matrix, a highly vascular collection of glial and neuronal precursor cells. This periventricular region is selectively vulnerable to haemorrhage in premature infants predominantly in the first 48 h of life. When the haemorrhage in the germinal matrix is substantial, the ependyma breaks, and the cerebral ventricle fills up with blood. Majority of these infants are asymptomatic and the diagnosis is based on screening cranial ultrasound.


Except for shunt insertion to divert cerebrospinal fluid in infants with posthaemorrhagic hydrocephalus and possibly the removal of blood clots in infants with high-grade IVH, there is no treatment for established IVH and no medical therapies exist to ameliorate the neurodevelopmental sequelae of IVH.