Intraventricular Hemorrhage (IVH)

Most cases occur within the first 7 days of life. Routine cranial ultrasound screening is performed during this period, followed by serial studies to monitor changes in the size and extent of the hemorrhage. A brain MRI may also be performed at term-equivalent age (approximately 40 weeks corrected age) or prior to NICU discharge.

IVH is graded based on severity:

• Grade 1: Subependymal hemorrhage
• Grade 2: IVH without ventricular dilation
• Grade 3: IVH with ventricular dilation
• Grade 4: IVH with parenchymal hemorrhage

Management focuses on preserving cerebral perfusion, preventing further brain injury, and promptly identifying complications.

• Strategies include minimal handling and careful blood pressure management to reduce the risk of bleeding progression.
• If hydrocephalus develops, cerebrospinal fluid drainage may be required.