What Is an Intraventricular Hemorrhage?
An intraventricular hemorrhage (in-treh-ven-TRIK-yeh-ler HEM-er-idge) is bleeding
in and around the brain's ventricles. The ventricles are spaces in the brain
filled with cerebral spinal fluid.
What Are the Signs & Symptoms of an Intraventricular Hemorrhage?
Doctors use grades to classify an intraventricular hemorrhage (IVH), from grade
1 to 4. Grades are based on the amount and location of bleeding in the brain. A grade
1 or grade 2 IVH can be mild and cause few or no problems. Grade 3 and grade 4 IVHs
have more bleeding and can be very serious.
Babies with a minor IVH often have no symptoms. Babies who have an IVH with more
serious bleeding can have:
- pauses in breathing (apnea)
- a slow heart rate
- anemia
- bulging at the "soft spot" on the baby's head (the fontanel)
- seizures
- a weak suck and poor feeding
- irritability
What Causes an Intraventricular Hemorrhage?
Babies who are born
early are more likely to develop an IVH. Those born very early or who are very
small are at greatest risk.
Blood vessels in babies born very early are not fully developed. Problems from
an early birth — such as low oxygen levels, changes in blood pressure, and breathing problems —
can damage these fragile blood vessels, making them leak.
Other reasons a baby might get an IVH include:
- a low birth weight (3 pounds or less)
- a difficult delivery
- bleeding problems
- an infection in the baby's mother
How Is an Intraventricular Hemorrhage Diagnosed?
Most IVHs happen within the first few days of life. Doctors use an ultrasound
scan of the head to diagnose the problem when a baby:
- is born early
- is born after a difficult delivery
- has symptoms of an IVH
- has risk factors for an IVH, such as needing breathing help from a ventilator
How Is an Intraventricular Hemorrhage Treated?
There is no specific treatment for an IVH. Newborns who have one are cared for
in a neonatal intensive
care unit (NICU). A team
of experts, including nurses and doctors who specialize in newborn care, will
watch for and treat any problems related to the IVH and early birth.
A baby with severe IVH may develop hydrocephalus,
a buildup of extra fluid in the brain's ventricles. Doctors will do head ultrasounds
regularly to look for this problem. To drain the fluid and relieve pressure in the
brain if it does happen, doctors can:
Most babies with a mild IVH do well. Babies born very early or who have a more
severe IVH are at risk for cerebral
palsy, seizures, developmental delays, and learning problems.
What Else Should I Know?
Preventing
premature birth is the best way to prevent an intraventricular hemorrhage. Doctors
can give steroid medicines to pregnant women who are likely to deliver their babies
early. Steroids help the baby's lungs
mature and decrease the chances of an IVH. Delayed cord clamping at delivery also
may help prevent it.
If your baby is born early, reach out to the NICU team for support. They are there
to help your baby and you. You also can find support and information online at:
Date reviewed: November 2019