Subependymal hemorrhage (SEH) into germinal matrix
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 |
References:
1. Bowerman R, Donn S, Silver T, Jaffe M. Natural history of neonatal periventricular/intraventricular hemorrhage and its complications: sonographic observations. American Journal of Roentgenology. 1984 Nov 1;143(5):1041–52.
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.