intraventricular hemorrhage luke johnson. overview ivh most common brain implication in premature...
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Intraventricular Hemorrhage
Luke Johnson
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
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
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.
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
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
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
Long term conditions• Cerebral palsy
• Learning
disability's
• ADHD
• Mental
retardation
• Severe motor
deficits
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.
Causes
• Caused solely by prematurity
• Prematurity causes an
underdeveloped CNS and week blood
vessel walls
• Past week 24, it tends to not occur
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
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
Prevalence
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.
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.
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
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