Intraventricular hemorrhage and posthemorrhagic hydrocephalus in preterm infants: diagnosis, classification, and treatment options

  • Paola Valdez Sandoval
  • Paola Hernández Rosales
  • Deyanira Gabriela Quiñones Hernández
  • Eva Alejandra Chavana Naranjo
  • Victor García NavarroEmail author
Review Article



Intraventricular hemorrhage is the most important adverse neurologic event for preterm and very low weight birth infants in the neonatal period. This pathology can lead to various delays in motor, language, and cognition development. The aim of this article is to give an overview of the knowledge in diagnosis, classification, and treatment options of this pathology.


A systematic review has been made.


The cranial ultrasound can be used to identify the hemorrhage and grade it according to the modified Papile grading system. There is no standardized protocol of intervention as there are controversial results on which of the temporizing neurosurgical procedures is best and about the appropriate parameters to consider a conversion to ventriculoperitoneal shunt. However, it has been established that the most important prognosis factor is the involvement and damage of the white matter.


More evidence is required to create a standardized protocol that can ensure the best possible outcome for these patients.


Intraventricular hemorrhage Posthemorrhagic hydrocephalus Ventricular access device Ventriculosubgaleal shunt Ventriculoperitoneal shunt 



Cerebral blood flow


Cerebral palsy


Cerebrospinal fluid


Drainage, irrigation, and fibrinolytic therapy


External ventricular drainage


Germinal matrix


Germinal matrix hemorrhage


Intraventricular hemorrhage


Lumbar puncture


Posthemorrhagic hydrocephalus


Periventricular hemorrhagic infarction


Real-time ultrasound


Temporizing neurosurgical procedures


Ventricular access device


Very low birth weight






Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Paola Valdez Sandoval
    • 1
  • Paola Hernández Rosales
    • 1
  • Deyanira Gabriela Quiñones Hernández
    • 1
  • Eva Alejandra Chavana Naranjo
    • 2
  • Victor García Navarro
    • 1
    • 3
    Email author
  1. 1.Department of Clinical SciencesTecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Campus GuadalajaraGuadalajaraMexico
  2. 2.Neonatology DepartmentNuevo Hospital Civil de Guadalajara, Juan I. MenchacaGuadalajaraMexico
  3. 3.Neurosurgery DepartmentNuevo Hospital Civil de Guadalajara, Juan I. MenchacaGuadalajaraMexico

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