Intraventricular hemorrhage

Overview

Intraventricular hemorrhage, or IVH, occurs when there's bleeding into or near the normal spaces within a baby's brain. Although the cause of IVH isn't completely known, premature babies have an increased risk of developing the condition because their blood vessels are very fragile and immature. As a result, they can easily burst and cause bleeding. The smaller and more premature the baby, the greater the risk of developing IVH.

Bleeding in the brain can put pressure on the nerve cells and cause damage. Severe damage to cells can lead to brain injury and cause motor problems or intellectual disability.

Signs & symptoms

Typically, there are no obvious signs that a baby is experiencing bleeding. However, symptoms of IVH may include:

• Apnea, when a baby stops breathing
• Bradycardia, when a baby has a low heart rate
• Pale or blue coloring, called cyanosis
• Weak suck
• High-pitched cry
• Seizures
• Swelling or bulging of the fontanelles, the soft spots between the bones of the baby's head
• Anemia, or low blood count

Diagnosis

Premature babies who are at an increased risk of developing intraventricular hemorrhage will be closely monitored and tested for the disease. These babies will usually have an ultrasound of their head within the first three to 10 days of life. The ultrasound will provide an inside view of the brain through the fontanelles, the spaces between the bones of the baby's head. If intraventricular hemorrhage is detected, the severity will be graded based on the amount of blood seen in the brain.

Treatment

Other than trying to prevent premature birth and treating health problems that may worsen a baby's condition and increase the risk of IVH, there's no specific treatment for the condition. However, giving mothers medications called corticosteroids before delivery has been shown to reduce the risk of IVH in babies.

If the IVH is severe enough that the ventricles in the brain enlarge and put the surrounding brain at risk for damage, a shunt may be required to drain the excess fluid that has built up in the ventricles. A shunt is placed by a surgical procedure, and it drains the excess fluid from the ventricles in the brain under the skin to the abdomen.