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IVH in the preterm brain usually arises from the germinal matrix whereas IVH in the term infants originates from the choroid plexus. However, it is particularly common in premature infants or those of very low birth weight. [9] The cause of IVH in premature infants, unlike that in older infants, children or adults, is rarely due to trauma.
This category includes intraparenchymal hemorrhage, or bleeding within the brain itself, and intraventricular hemorrhage, bleeding within the brain's ventricles (particularly of premature infants). Intra-axial hemorrhages are more dangerous and harder to treat than extra-axial bleeds. [8]
It is most frequent before 35 weeks gestation and is typically seen in very low birth-weight (<1500g) premature infants, because they lack the ability for auto regulation of cerebral blood flow. Consequently, increased arterial blood pressure in these blood vessels leads to rupture and hemorrhage into germinal matrix.
The other form is intraventricular hemorrhage). [1] Intraparenchymal hemorrhage accounts for approximately 8-13% of all strokes and results from a wide spectrum of disorders. It is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage, and therefore constitutes an immediate medical emergency.
Intraventricular hemorrhage (IVH), also known asintraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from physical trauma or from hemorrhagic stroke.
However, breathing difficulties, intraventricular hemorrhage, necrotizing enterocolitis and infections still claim many infant lives and are the focus of many new and current research projects. The long-term outlook for premature babies saved by NICUs has always been a concern.
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Perinatal asphyxia can be the cause of hypoxic ischemic encephalopathy or intraventricular hemorrhage, especially in preterm births. An infant with severe perinatal asphyxia usually has poor color , perfusion, responsiveness, muscle tone, and respiratory effort, as reflected in a low 5 minute Apgar score.