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)