Substance use (e.g., heavy alcohol use, heroin, cocaine)
Maternal or fetal stress
Maternal age (≤ 18 years, > 35 years)
Pathophysiology
Clinical features
Diagnostics
Treatment
Complications
Intraventricular hemorrhage (IVH)
Definition: Bleeding into the ventricles from the germinal matrix, a highly vascularized region within the subventricular zone of the brain from which cells migrate out during brain development.
Etiology: associated with a number of risk factors
Birth weight < 1500 g and delivery before 32 weeks’ gestation due to the fragility of the germinal matrix and/or impaired autoregulation of blood pressure
Maternal chorioamnionitis
Pathophysiology
Immaturity of the basal lamina and lack of astrocytic glial fibrillary acidic protein within the germinal matrix leads to abnormal cerebral autoregulation.
Alterations in an infant’s blood pressure (e.g., during birth, intubation) → failure of cerebral autoregulation to compensate for the change in blood pressure → rupture of and bleeding from vessels in the germinal matrix → rupture of ependyma → blood flows into the ventricles
Clinical features
Usually occurs within the first days of life (up to day 5)
Most infants are asymptomatic, but saltatory (for several days) or, more rarely, catastrophic (over minutes to hours) courses are also possible.
