Germinal matrix hemorrhage - grade III

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Weak cry and impaired sucking

Patient Data

Age: 20 days old preterm baby
Gender: Female

Subependymal hemorrhage extends to both lateral ventricles with formation of CSF/Blood level at occipital horns. Associated periventricular leukomalacia (PVL) more on the left side and moderate dilatation of all ventricular system are noted.

Diagnosis: Germinal matrix hemorrhage Grade III with communicating hypdrocephalus and periventricular leukomalacia

Case Discussion

Germinal matrix usually disappears after 32 weeks of gestations and hence persists in premature children. It has weak blood vessels which in response to ischemia rupture leading to hemorrhage. The hemorrhage may be localized at subependymal region (Grade I) or extends to the lateral ventricles without hyrocephalus (Grade II) or with hydrocephalus (Grade III) or extends to brain parenchyma (Grade IV)

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