Intraventricular Hemorrhages & CP
An intraventricular hemorrhage (IVH) is characterized by a bleeding in the brain’s ventricular system, and is sometimes caused by physical trauma to the child during labor.
Intraventricular hemorrhages usually occur within the first 72 hours of childbirth, and are particularly common in premature infants or babies with a very low birth weight.
When there is bleeding in the brain, it can damage or even kill areas within the brain that are critical to cognitive development and motor function. An intraventricular hemorrhage can result in the development of hydrocephalus or a subdural hematoma, which can also lead to permanent brain damage either via compression of the tissue or a reduction in the brain’s blood supply.
The severity of the impairment is contingent upon the location and the amount of damage that occurred, but any such brain injury can develop into a neurological disorder such as cerebral palsy.
Risk Factors of Intraventricular Hemorrhage
The risk factors for the development of IVH include, but are not limited to the following:
- Abnormal blood clotting
- Pelvic inflammatory disease
- Head injury
- Hypertension during pregnancy
- Shaken baby syndrome
- Maternal infection
- Abnormal blood vessels in the brain
- Hypoxic ischemic encephalopathy
- Trauma during childbirth
Levels of Severity & Related Injuries
All four grades of an intraventricular hemorrhage can present significant dangers to both pre- and post-term infants, especially grades III and IV.
- Grade I — Where bleeding occurs only in the germinal matrix.
- Grade II — Where bleeding also occurs inside the ventricles (but ventricles are not enlarged).
- Grade III — Where the ventricles are enlarged by the accumulation of blood.
- Grade IV — Where bleeding extends into the brain tissue around the ventricles.
There are also other types of similar and/or related forms of intracranial hemorrhages, as identified below.
- Epidural Hematoma (EDH) — In most cases, an epidural hematoma (also known as extradural hematoma) follows sudden head trauma or neonatal stroke. Such trauma can be caused by compression within the birth canal, improper use of delivery forceps and/or vacuum extractor, or other head injuries.
- Subdural Hematoma (SDH) — A subdural hematoma is more serious than an epidural hematoma, and is most-often caused by direct trauma or serious acceleration-deceleration of the head (shaken baby syndrome). A subdural hematoma can increase intracranial pressure, causing damage to delicate brain tissue. Although a child who suffers SDH may improve, it is very likely the child will experience permanent loss of brain function — especially if not mitigated immediately. This particular type of brain injury has an extremely high rate of mortality because of the significantly-high incidence of irreversible brain damage.
- Subarachnoid Hematoma (SAH) — A subarachnoid hematoma is the second-most-common type of hemorrhage that follows any birth-related trauma. Babies who develop these types of hemorrhages will in all likelihood suffer seizures within 48 hours following their birth.
- Intracerebral Hemorrhage (ICH) — An intracerebral hemorrhage usually occurs in the basal ganglia, cerebellum, brain stem, or cortex, and is characterized by an accumulation of blood within the cranial vault caused by a ruptured blood vessel (stroke). An ICH can occur due to trauma, infection, blood clotting deficiencies, and abnormalities in the child’s blood vessels.