What is a Grade 1 germinal matrix hemorrhage?
Grade 1: Hemorrhage that is confined to the germinal matrix. Grade 2: Extension of the hemorrhage into the lateral ventricles without hydrocephalus. Grade 3: Ventricular hemorrhage with the presence of associated hydrocephalus.
What is a germinal matrix hemorrhage?
Germinal matrix hemorrhages, also known as periventricular-intraventricular hemorrhages (PVIH), are the commonest type of intracranial hemorrhage in neonates and are related to perinatal stress affecting the highly vascularized subependymal germinal matrix.
What percentage of premature infants may have intracranial hemorrhage?
Occurring with nearly 15% of premature births (<37 weeks); and gestational age (often clinically related to body weight) is the most important clinical predictor of brain hemorrhage.
What is a grade 1 hemorrhage?
These are called “grades” and are based on the degree of bleeding. Grades 1 and 2 involve a smaller amount of bleeding. Most of the time, there are no long-term problems as a result of the bleeding. Grade 1 is also referred to as germinal matrix hemorrhage (GMH). Grades 3 and 4 involve more severe bleeding.
What does the germinal matrix do?
In anatomy, the germinal matrix is a highly cellular and highly vascularized region in the brain out from which cells migrate during brain development. The germinal matrix is the source of both neurons and glial cells and is most active between 8 and 28 weeks gestation.
What does it mean if a premature baby has bleeding on the brain?
After birth, the premature baby’s brain is exposed to changes in blood flow and oxygen levels. This may cause the blood vessels to break and bleeding to occur. It happens mostly in babies who are extremely premature or who have medical problems during or after birth.
Is it common for preemies to have brain bleeds?
As many as 30% of babies born weighing less than 1,000 grams (about 2 pounds, 4 ounces) have intraventricular hemorrhages. Most of these bleeds are mild (Grade I or II), and about 90% resolve with few or no problems. In mild cases, the body absorbs the blood. Usually the follow-up head ultrasound is normal.
Why do premature babies get IVH?
The smaller and more premature an infant is, the higher the risk for IVH. This is because blood vessels in the brain of premature infants are not yet fully developed. They are very fragile as a result. The blood vessels grow stronger in the last 10 weeks of pregnancy.
When does germinal matrix go away?
Gestational age is the most important single independent risk factor. The germinal matrix reaches its maximum volume around 25 weeks gestation and subsequently withers. A residual mass persists until ~36 weeks gestational age. A venous origin of GMH-IVH has been demonstrated by postmortem studies11,12 (Fig.