Subependymal hemorrhage or germinal matrix hemorrhage occurs in premature infants with very low birth weight (<1500g). The germinal matrix in the immature brain is located around the lateral ventricles and it contains a fine network of fragile blood vessels, which are sensitive to ischemia and changes in perfusion pressure. Subependymal hemorrhage in premature neonates can be easily assessed by ultrasound and be divided into four grades.
Grade | Description |
---|---|
Grade I | hemorrhage confined to the germinal matrix |
Grade II | intraventricular hemorrhage (hemocephalus) without ventricular dilation |
Grade III | intraventricular hemorrhage (hemocephalus) with ventricular dilation |
Grade IV | intraventricular rupture with hemorrhage into the surrounding white matter |
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2. Radack DM, Baumgart S, Gross GW. Subependymal (grade 1) intracranial hemorrhage in neonates on extracorporeal membrane oxygenation. Frequency and patterns of evolution. Clin Pediatr (Phila). 1994 Oct;33(10):583–7.
3. Smith WL, McGuinness G, Cavanaugh D, Courtney S. Ultrasound screening of premature infants: longitudinal follow-up of intracranial hemorrhage. Radiology. 1983 May 1;147(2):445–8.
ASPECTS is a quantitative topographic prognostic score based on unenhanced CT scan in patients with middle cerebral artery infarction. For each from 10 segments, one point is deducted from initial 10 points for each segment with detectable ischemic changes. A score ≤7 points predicts worse functional outcome at 3 months and an increased risk of symptomatic intracranial hemorrhage.
Caudate
Putamen
Capsula interna
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