Overview
Intraventricular haemorrhage (IVH) describes bleeding into the ventricular system of the brain, where cerebrospinal fluid (CSF) is produced. It is rare in adults and more common in neonates within 72 hours of birth.
Its aetiology is not fully understood but is thought to be due to a combination of birth trauma and fragility of the neonatal central nervous system (CNS).
It is recommended that neonates are given vitamin K to reduce the risk of intraventricular haemorrhage.
Risk Factors
Risk factors for IVH include:
- Prematurity
- Low birth weight
- Hypoxia
- Sepsis
- Respiratory distress syndrome
- Hypo- and hypertension
- Hypovolaemia
Presentation
Overview
Features tend to present on the third day of life, however, they can be vague:
- Diminished/absent Moro reflex
- Reduced muscle tone
- Reduced consciousness – lethargy, drowsiness, may progress to coma
- Apnoea
- Seizures
- Pallor or cyanosis
- Bulging fontanelle if IVH is severe
Management
Treatment is mainly supportive. Shunting is performed if raised intracranial pressure and/or hydrocephalus develop.
