Intraventricular Hemorrhage Luke Johnson

Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped CNS and germinal matrix 24 weeks of gestation Categorized into different Grades

Grades of IVH The severity of IVH is divided into Grade I-IV As the number of the Grade increases, so does the chance of death and long term problems

Grade I The is contained only in the germinal matrix Grade I IVH is not life threatening and generally has no long term complications unless something unexpected occurs.

Grade II Bleeding exceeds the germinal matrix and seeps into the ventricle or ventricles The ventricles do not enlarge Generally not a big deal as well Death rate and long term complications are still small but increased due to a chance for hydrocephalus

Grade III Grade III is when IVH becomes very serious Bleeding is severe and causes the ventricles to enlarge due to extra blood. Pressure inside the ventricles push the surrounding brain matter increasing stress on brain. This can be life threatening and have long term complications Hydrocephalus is common

Grade IV Extremely dangerous Blood has burst through the ventricles and extends into the brain tissue around the ventricles Death and/or brain complications are generally expected in a Grade IV IVH Brain is pushed downward in the skull sometimes

Long term conditions Cerebral palsy Learning disability's ADHD Mental retardation Severe motor deficits

Symptoms Tend to not show symptoms Doctors have to assume IVH and detect it by a cranial ultrasound In severe IVH (Grade III and IV), some babies have a severe decrease in their hematocrit, have seizures, irritability, or severe metabolic acidosis.

Causes Caused solely by prematurity Prematurity causes an underdeveloped CNS and week blood vessel walls Past week 24, it tends to not occur

Tools Cranial Ultrasound- used in detection of IVH VAD- Ventricular Access Device is a device placed underneath the scalp of an infant connected with a tube Ventriculo-peritoneal shunt- A device very similar to the VAD except it constantly drains the ventricle in more extreme hydrocephalus conditions into the peritoneal cavity

Treatment/Management Once IVH has occurred, there is no way to stop it Results of IVH can be managed however Hydrocephalus is the main problem caused by IVH and can be managed quite well

Prevalence

Prognosis Depending on the severity of IVH, the prognosis can either be no long term ailments at all to the loss of all motor functions. Grades I-II tend to have no long term damage at all, but when the ventricles start to swell, long term damage tends to appear. Grades III-IV lead to cerebral palsy, mental retardation, ADHD, learning disabilities, loss of motor skills, and some researchers have even linked it to eating disorders.

Impact on Society 17 billion dollars in in medical and health care costs 2 billion dollars in labor and delivery costs for the mother 611 million dollars for early intervention services. These are programs for children from birth to age 3 with disabilities and developmental delays. They help children learn physical, thinking, communicating, social and self-help skills that normally develop before age billion for special education services. These services are specially designed for children with disabilities ages 3 through 21. They help children with development and learning. Children can get these services at school, at home, in hospitals and in other places, as needed. 5.7 billion in lost work and pay for people born prematurely.

March of Dimes Support group "We help moms have full- term pregnancies and research the problems that threaten the health of babies." Prematurity Campaign Prematurity Awareness Month Fundraising