Bleeding into the ventricles inside the brain; in neonates occurs mainly in premature infants

Pathophysiology

• Germinal matrix is the most common type - related to perinatal stress affecting the highly vascularised germinal matrix
• By 35-36 weeks gestation, the germinal matrix has essentially disappeared and thus the risk of haemorrhage is markedly reduced

Classification

• Grade 1 and 2 - neurodevelopmental delay up to 20%, mortality 10%
• Grade 3 and 4 - neurodevelopmental delay up to 80%, mortality 50%

Clinical features

• Apnoeas
• Decreased reflexes
• Excessive sleep
• Lethargy
• Weak suck

Investigations

• Imaging: ultrasound/CT head

Management

• Supportive