What is intraventricular hemorrhage?

What is intraventricular hemorrhage?

What is intraventricular hemorrhage?

Intraventricular hemorrhage occurs when there is bleeding in or around the ventricles of the brain. This condition is more common in premature babies (although variants of it occur in all age groups).

An intraventricular hemorrhage can put pressure on the nerves in the brain and cause injury and permanent damage.

When does intraventricular hemorrhage occur?

This condition is not usually present at birth but occurs within the first three to four days after birth. It is important to understand the signs and what to do if your child has it.

Babies born before 30 weeks or babies weighing less than 2.5 kg are advised to have an ultrasound within a few days of birth. This is one of the most effective ways to find out if the baby is suffering from intraventricular hemorrhage. After 1 month outside the uterus, there is virtually no risk of intraventricular hemorrhage.

Degrees of intraventricular hemorrhages

From I to IV degree:

  • Grade I - Bleeding from the ventricles in small areas (also known as germline hemorrhage)
  • Grade II - intraventricular bleeding.
  • Grade III - The blood causes the ventricles to enlarge and presses on the brain tissue.
  • Grade IV - blood is found in the brain tissue surrounding the ventricles (also known as intraparenchymal hemorrhage).

Grades 1 and 2 are the most common and refer to less bleeding. Typically, a grade 1 or 2 hemorrhage does not cause permanent damage and is treatable.

Grades 3 and 4 are diagnosed when bleeding has entered the ventricles so much that they have enlarged, and blood clots can block the flow of cerebrospinal fluid. This increases the amount of fluid in the brain, also known as hydrocephalus.

Cause

There is no easily determined cause of intraventricular hemorrhage. This condition occurs because the blood vessels are not fully developed or are not strong enough to support blood flow (which is why it is rare in more developed children).

While it can be caused by head trauma or labor pressure, it can also happen without much warning or reason.

Many factors can contribute to the likelihood of this condition. Premature babies are most at risk, especially those born ten weeks earlier or earlier. The more premature a baby is, the higher the risk of this and other health complications.

Premature babies born with breathing problems or other complications of prematurity are also at higher risk. Babies who have other blood problems, infections, and/or shaken baby syndrome have an increased risk of intraventricular hemorrhage.

Symptoms

Occasionally, children with intraventricular hemorrhage may have few or no obvious symptoms. In other cases, various symptoms may occur.

Because many of these symptoms can also indicate other conditions, it's important to seek medical attention if you notice any of the following symptoms:

  • Apnea, or trouble breathing
  • Decreased or slow reflexes
  • Lethargy or baby is sleeping abnormally extended periods of time/often
  • Changes in heart rate
  • Weak suck during breastfeeding
  • Seizures
  • High-pitched crying
  • Pale or blue coloring of the skin
  • Decreased muscle tone

While none of these symptoms are a sure sign of intraventricular hemorrhage, they can all indicate a serious problem and should be brought to the attention of a healthcare professional.

An ultrasound of the head and blood tests can determine if the baby has intraventricular hemorrhage and to what extent.

Ultrasound can also help determine if the child has another disease or complication.

Common treatments

There is no natural cure for intraventricular hemorrhage, but there are steps doctors and mothers can take to prevent or reduce the effects of this condition.

Mothers at high risk of preterm birth may be prescribed certain steroids to reduce the risk of them developing in a premature baby.

If a child is found to have an intraventricular hemorrhage, doctors may try to reduce symptoms and stabilize the child to prevent further damage while it heals.

In the most extreme cases, surgery may be used to try and stabilize the child. Before surgery, doctors may drain cerebrospinal fluid with a needle or through less invasive surgery to relieve pressure on the ventricles.

Typically, children with less severe intraventricular hemorrhage heal spontaneously; however, medical care can give them the best chance of recovery with little or no damage.

Prognosis of intraventricular hemorrhage

The outcome depends on the severity of intraventricular hemorrhage and the degree of prematurity of the child during its development. The more developed a child is, the less he is at risk.

Most children suffering from grade 1 or 2 will survive with minimal damage.

Less than a third of children in grades 3 or 4 die from it or may suffer serious long-term damage.

With proper treatment and early detection, the prognosis can be very promising in most cases.

Tips for preventing intraventricular hemorrhage

It is difficult to prevent intraventricular hemorrhages, except for some medications that can reduce the risk and of course provide excellent care for premature babies.

Other factors that may help reduce the risk of intraventricular hemorrhage include:

  • Delivery in a hospital with a neonatal intensive care unit (so that babies can be treated faster and with minimal movement)
  • Delayed cord clamping or cord blowing
  • Take vitamin K before giving birth (especially for women who may be taking medications that interfere with blood flow and increase the risk of bleeding).
  • If your baby was born prematurely or you are particularly concerned about this condition, talk to your doctor to find out what steps you can take to prevent and treat intraventricular hemorrhage. 

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