Neonatal Intraventricular Hemorrhage

  • Etiology: poor cerebral autoregulation, hypo-or hypertensive arterial event leads to germinal matrix hemorrhage (arterial event -> germinal matrix hemorrhage)
  • Imaging: Grade I is focal germinal matrix hemorrhage, Grade II is germinal matrix hemorrhage + intraventricular hemorrhage without ventricular dilation, Grade III is germinal matrix hemorrhage + intraventricular hemorrhage with ventricular dilation
  • Complications: communicating hydrocephalus from obstructed pacchionian granulations

Radiology Cases of Neonatal Intraventricular Hemorrhage Grade I

MRI of neonatal intraventricular hemorrhage Grade I
Coronal T1 MRI with contrast of the brain (left) shows an enhancing lesion in the right germinal matrix that is of low signal intensity on gradient echo (right). There was no evidence on hemorrhage in the lateral ventricles.

Radiology Cases of Neonatal Intraventricular Hemorrhage Grade II

US of intraventricular hemorrhage
Coronal (above left), left sagittal (above middle) and right sagittal (above right) US of the head shows a round echogenic focus in the left germinal matrix. There was also an echogenic focus in the occipital horn of the left lateral ventricle (not provided). The ventricular system was normal in size. Followup exam from 2 weeks later (below) shows interval decrease in size and cavitation of the echogenic foci in the left germinal matrix and occipital horn of the left lateral ventricle. The ventricular system is minimally increased in size.

Radiology Cases of Neonatal Intraventricular Hemorrhage Grade III

Head US of neonatal intraventricular hemorrhage grade III and periventricular hemorrhage
Coronal US of the brain shows increased echogenicity within the anterior horn of the left lateral ventricle with ventricular dilation (upper) and increased echogenicity within the brain parenchyma in the left anterior periventricular region and right temporal region (lower left) and in the bilateral posterior periventricular regions (lower right).
US of intraventricular hemorrhage grade III
Coronal US of the brain shows echogenic material within the bilateral dilated lateral ventricles.