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Intraventricular Hemorrhage in the Premature Infant

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Common Neurosurgical Conditions in the Pediatric Practice

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Abstract

Despite marked improvements in perinatal care, the smallest premature infant remains at high risk for the development of intraventricular hemorrhage. The pathogenesis of the hemorrhage includes vulnerable poorly supported capillary beds within the germinal matrix, with the propensity for rupture of these vessels under conditions where there are perturbations in systemic blood/venous pressures that maybe reflected in the cerebral circulation, particularly with a pressure passive state. Blood filling the ventricles, particularly when followed by hydrocephalus, and/or associated involvement of the periventricular white matter markedly increases the risk for neurologic deficits. The extent of hemorrhage can be minimized if the mother receives a course of antenatal steroids shortly prior to delivery, in the postnatal period with the early administration of indomethacin and by avoiding vascular perturbations. The management of post hemorrhagic hydrocephalus will depend on the size of the infant, the amount of blood in the ventricles and the intracranial pressure.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY, 10065, USA

    Jeffrey M. Perlman M.B., Ch.B.

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  1. Jeffrey M. Perlman M.B., Ch.B.
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Correspondence to Jeffrey M. Perlman M.B., Ch.B. .

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Editors and Affiliations

  1. Associate Professor of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA

    Jeffrey P. Greenfield

  2. Manhattan Pediatrics, New York, New York, USA

    Caroline B. Long

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Perlman, J.M. (2017). Intraventricular Hemorrhage in the Premature Infant. In: Greenfield, J., Long, C. (eds) Common Neurosurgical Conditions in the Pediatric Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3807-0_11

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  • DOI: https://doi.org/10.1007/978-1-4939-3807-0_11

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