Pathophysiology of Germinal Matrix-Related Hemorrhage and Ischemia
A wide variety of intracranial pathology is found in the newborn infant. Two unique lesions, however, affect the premature brain. On the basis of what is presently known, these two lesions superficially appear to have very different origins, yet both are rooted in the fetal anatomy and physiology that persist in the premature infant. The better known of these two lesions is germinal matrix-related hemorrhage (GMRH). Although four major forms of intracranial hemorrhage may affect newborn infants, only GMRH has been specifically related to gestational immaturity. The second lesion, peri ventricular leukomalacia (PVL), appears to be ischemic in nature and primarily affects the periventricular white matter. Although PVL is considerably less common than GMRH, it is acquiring increasing importance because it is almost invariably associated with poor developmentaloutcome, as will be seen in the chapter on follow-up of these infants.
KeywordsCerebral Blood Flow Premature Infant Cerebral Blood Flow Velocity Periventricular White Matter Periventricular Leukomalacia
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