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Intraventricular Hemorrhage Luke Johnson

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Page 1: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Intraventricular Hemorrhage

Luke Johnson

Page 2: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped
Page 3: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Overview

• IVH

• Most common brain implication in premature

babies

• Bleeding into the ventricles

• Underdeveloped CNS and germinal matrix

• 24 weeks of gestation

• Categorized into different Grades

Page 4: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Grades of IVH

• The severity of IVH is divided into

Grade I-IV

• As the number of the Grade

increases, so does the chance of

death and long term problems

Page 5: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Grade I• The is contained only in the germinal

matrix

• Grade I IVH is not life threatening

and generally has no long term

complications unless something

unexpected occurs.

Page 6: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Grade II • Bleeding exceeds the

germinal matrix and seeps

into the ventricle or

ventricles

• The ventricles do not enlarge

• Generally not a big deal as

well

• Death rate and long term

complications are still small

but increased due to a

chance for hydrocephalus

Page 7: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Grade III• Grade III is when IVH

becomes very serious

• Bleeding is severe and causes

the ventricles to enlarge due

to extra blood. Pressure

inside the ventricles push the

surrounding brain matter

increasing stress on brain.

• This can be life threatening

and have long term

complications

• Hydrocephalus is common

Page 8: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Grade IV• Extremely dangerous

• Blood has burst through

the ventricles and extends

into the brain tissue

around the ventricles

• Death and/or brain

complications are

generally expected in a

Grade IV IVH

• Brain is pushed downward

in the skull sometimes

Page 9: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Long term conditions• Cerebral palsy

• Learning

disability's

• ADHD

• Mental

retardation

• Severe motor

deficits

Page 10: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Symptoms

• Tend to not show symptoms

• Doctors have to assume IVH and detect it

by a cranial ultrasound

• In severe IVH (Grade III and IV), some

babies have a severe decrease in their

hematocrit, have seizures, irritability, or

severe metabolic acidosis.

Page 11: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Causes

• Caused solely by prematurity

• Prematurity causes an

underdeveloped CNS and week blood

vessel walls

• Past week 24, it tends to not occur

Page 12: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Tools• Cranial Ultrasound- used in

detection of IVH

• VAD- Ventricular Access

Device is a device placed

underneath the scalp of an

infant connected with a tube

• Ventriculo-peritoneal shunt- A

device very similar to the VAD

except it constantly drains the

ventricle in more extreme

hydrocephalus conditions into

the peritoneal cavity

Page 13: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Treatment/Management • Once IVH has occurred, there is no

way to stop it

• Results of IVH can be managed

however

• Hydrocephalus is the main problem

caused by IVH and can be managed

quite well

Page 14: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Prevalence

Page 15: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Prognosis

• Depending on the severity of IVH, the prognosis can

either be no long term ailments at all to the loss of

all motor functions. Grades I-II tend to have no long

term damage at all, but when the ventricles start to

swell, long term damage tends to appear. Grades III-

IV lead to cerebral palsy, mental retardation, ADHD,

learning disabilities, loss of motor skills, and some

researchers have even linked it to eating disorders.

Page 16: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

Impact on Society• 17 billion dollars in in medical and health care costs

• 2 billion dollars in labor and delivery costs for the mother

• 611 million dollars for early intervention services. These are programs

for children from birth to age 3 with disabilities and developmental

delays. They help children learn physical, thinking, communicating,

social and self-help skills that normally develop before age 3.

• 1.1 billion for special education services. These services are specially

designed for children with disabilities ages 3 through 21. They help

children with development and learning. Children can get these services

at school, at home, in hospitals and in other places, as needed.

• 5.7 billion in lost work and pay for people born prematurely.

Page 17: Intraventricular Hemorrhage Luke Johnson. Overview IVH Most common brain implication in premature babies Bleeding into the ventricles Underdeveloped

March of Dimes• Support group

• "We help moms have

full-term pregnancies

and research the

problems that threaten

the health of babies."

• Prematurity Campaign

• Prematurity Awareness

Month

• Fundraising