Intraventricular Haemorrhage and Periventricular Leucomalacia Flashcards
What is the significance of IVH in preterm infants?
IVH is a major long-term health burden for prematurely born infants, causing devastating brain injuries.
What is the location of the primitive neural cells in the fetal brain?
The primitive neural cells are located around the base of the lateral ventricles, forming the germinal matrix.
Why is the germinal matrix vulnerable in preterm infants?
The germinal matrix is vulnerable due to its transient vascular system, lacking autoregulation for changes in flow or pressure.
What is PVL?
PVL refers to the necrosis of white matter around the ventricles of the brain in premature infants.
What can cause PVL?
PVL can be caused by hypoxic-ischemic injury or inflammation in the periventricular region.
What are the long-term consequences of PVL?
PVL can lead to motor and cognitive impairments in affected infants.
What is the germinal matrix?
The germinal matrix is a region around the base of the lateral ventricles in the fetal brain where primitive neural cells migrate and develop.
What occurs in the germinal matrix before 34 weeks of gestation?
Before 34 weeks of gestation, primitive neural cells in the germinal matrix migrate to form long corticospinal neurons or supporting cells.
How is the vascular system in the germinal matrix described?
The vascular system in the germinal matrix is transient and rich, suited for intrauterine life but with minimal capacity to autoregulate flow or pressure.
What events in a preterm infant’s life can affect cerebral blood pressure and vessel integrity?
Intubation,
a patent ductus arteriosus,
sudden volume expansion from IV fluids,
septicaemia, and
artificial ventilation can alter cerebral blood pressure and vessel integrity.
What can happen if the vessels in the germinal matrix rupture?
If the vessels rupture, blood can leak into the brain parenchyma, damaging the evolution of long tracts and their supporting stroma, especially those serving the legs closest to the ventricles
What is the potential consequence of blood leaking into the ventricles?
Blood leaking into the ventricles can cause altered cerebrospinal fluid (CSF) production and flow, potentially leading to hydrocephalus.
What grading system is used to describe the severity of GMH/IVH?
The grading system consists of Grades I to IV, based on the volume of blood in the parenchyma and ventricles.
Describe Grade I GMH/IVH.
Grade I indicates bleeding confined to the germinal matrix.
What defines Grade II GMH/IVH?
Grade II involves GMH and IVH occupying less than 50 percent of the lateral ventricle volume.