Intraventricular haemorrhage (IVH) is bleeding inside or around the ventricles of the brain. The ventricles are four small spaces deep inside the brain that help produce and store cerebrospinal fluid. Cerebrospinal fluid has many functions, such as cushioning the brain, washing away toxins, and providing nourishment. It naturally flows around and away from the brain and into the spinal cord.
Intraventricular haemorrhage is graded based on how severe the bleeding is:
There may be no symptoms of intraventricular haemorrhage. Of those that do have symptoms, they can include:
The blood vessels of preterm infants are fragile and not fully developed. This is because they normally strengthen over the last ten weeks of pregnancy. In a preterm infant, the fragile blood vessels are prone to bursting. If the blood vessel bursts, the blood can then flow into the ventricles and the cerebrospinal fluid.
IVH is most common in preterm low birth weight babies weighing less than 1500 grams at birth. While almost never present at birth, IVH presents within the first four days in most cases. It very rarely presents after a month.
Other risk factors include children who have:
Routine screening for IVH is done for all babies born at less than 30 weeks’ gestation. A head ultrasound is used to look for bleeding at 7-14 days of life. The ultrasound may be repeated when the baby reaches their original due date. In some cases, other imaging such as a CT scan or MRI may be required.
There is no way to stop the bleeding of IVH. The healthcare team will monitor the baby and treat for symptoms and other associated conditions.
If hydrocephalus occurs, the doctors may need to drain the extra fluid from the brain. This is done by inserting a drain into the spinal cord. In some cases, doctors may need to insert a permanent shunt to drain fluid off the brain to another area of the body, such as the heart or abdomen.
Complications are more common in severe cases. These can include:
Some things to prevent intraventricular haemorrhage include:
The symptoms of intraventricular haemorrhage are similar to other conditions and medical problems. If your baby is presenting concerning symptoms, it is important to seek medical attention right away.