Intraventricular Hemorrhage in Full-Term Neonate

Jeon, Myoung Bae; Park, Kook In; Yoon, Choon Sik; Namgung, Ran; Lee, Chul; Han, Dong Gwan

Original Article

Journal of the Korean Pediatric Society 1994;37(6):776-785.
Published online June 15, 1994.

Intraventricular Hemorrhage in Full-Term Neonate

Myoung Bae Jeon¹, Kook In Park², Choon Sik Yoon³, Ran Namgung², Chul Lee², Dong Gwan Han²

¹Department of Pediatrics, Incheon Christian Hospital , Incheon, Korea
²Department of Pediatrics, College of Medicine, Yonsei University, Seoul,Korea
³Department of Diagnostic Radilolgy, College of Medicine, Yonsei University, Seoul,Korea

만삭아에서 발생한 뇌실내 출혈

전명배^¹^, 박국인^²^, 윤춘식^³^, 남궁란^²^, 이철^²^, 한동관^²

^¹인천기독병원 소아과
^²연세대학교 의과대학 소아과학교실
^³연세대학교 의과대학 진단방사선과학교실

Abstract

Intraventricular hemorrhage is a common hemorrhagic cerebral disorder in premature, but occurs much less frequently in the full-term newborn. In order to obtain documentation of clinical and ultrasonographic characteristics of intraventricular hemorrhage in full-term, we performed cerebral ultrasonography on 602 newborn infants who had been admitted to neonatal intensive care unit at the Deppartment of Pediatrics, Yonsei University College of Medicine Between December 1989 and June 1991. 15 cases (2.5%) of intraventricular hemorrhage were analysed. The results were as follows: 1) Among 15 cases with intraventricular hemorrhage, there was no obstetrical and perinatal complication in 8 cases (53%) and 13 cases (87%) were neurologically normal at birth. 2) Sudden onset of dramatic neurologic abnormalitis inclued seizures, fever, bulging fontanel, irritability, lethargy, vomiting in 11 cases (73%) and the remainder (27%) had no clinical symptoms and signs. 3) The age at diangosis of hemorrhage was before 72 hours in 5 cases (33%), between 4 and 7 days in 2 cases 913%), at 8 to 28 days in 8 cases (53%), 8 of 15 cases (53%) had Grade I IVH, four with Grade II, 2 cases with Grade III, and 1 case of these infant demonstrated Grade IV IVH. The source of hemorrhage was subependymal germinal matrix in 12 cases (80%) and choroid plaxus in 3 cases (20%). 4) Precipitating factors were cerebral venous infarction in 7 cases, hypoxic ischemic injury in 5, and 3 other infants had no identifiable medicla risk factors. 5) Among all 15 survivors, 2 of 3 infants with choroid plexus hemorrhage required placement of a ventriculo-peritoneal shunt, in the other case, ventriculomegaly decreased spontaneously.

Key Words: Intraventricular hemorrhage, Full-term neonate