Intraventricular Hemorrhage (IVH)

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Intraventricular Hemorrhage (IVH) is a type of bleeding in the brain that is mostly likely to occur in babies who are born before 32 weeks of pregnancy.

Most intraventricular hemorrhages occur in the first week of life.

What are the symptoms of IVH?

If your baby has this condition, his or her symptoms could include:

• Paleness
• Breathing problems
• Weak heart rate
• Low blood pressure

In severe cases, your baby could have seizures.

Diagnosing Intraventricular Hemorrhage

If your baby is born more than 6 weeks premature, its typical for your doctor to order an ultrasound scan of the baby's brain. This will not bother your baby and will be done every few days for the first week and then as needed.

Intraventricular Hemorrhage Treatment

Unfortunately, there is no way to stop IVH from happening. The best approach is to try to keep the brain from bleeding by keeping the baby as stable as possible. When IVH does occur, it is treated by looking for and treating the complications of the bleeding.

If there is bleeding, head ultrasound scans will be used to check if the bleeding has gotten worse and look for clearing of any blood clots. Most of the time, the body gets rid of small amounts of the blood over several weeks.

Your doctor will treat any lung conditions and infections and, if necessary, help the baby breathe. If needed, a blood transfusion will keep your baby's blood pressure and blood count stable, and he or she will be treated for any seizures that occur.

Small amounts of bleeding usually do not cause any long-term damage.
Larger amounts of bleeding can cause long-term problems. Large amounts of bleeding can block the circulation system for the cerebrospinal fluid, which is called hydrocephalus.

After IVH occurs, the hospital staff watches closely for the development of hydrocephalus. If it occurs, there are treatments to keep the pressure under control. A baby who has hydrocephalus may not have any symptoms at first. Sometimes as the hydrocephalus progresses, the baby becomes sleepy, has more apnea (breathing pauses), or throws up feedings. Sometimes, the only sign of hydrocephalus is that the head grows too quickly.

Your doctor can tell if hydrocephalus is developing by looking at the size of the ventricles on the ultrasounds. Treatment for hydrocephalus is begun if the ventricles grow to a size that is thought to be harmful or if the baby has symptoms. This treatment could include spinal taps, to remove spinal fluid from the spinal canal to relieve pressure, or placing tubing surgically into the ventricles or a shunt, which is a permanent type of tube can be placed in the ventricles.

Long Term Effects of Intraventricular Hemorrhage

There is no test or examination that can accurately predict what a baby will be like as a child or adult. Only time and growth will show whether the brain has been permanently damaged. Usually, babies who have had small amounts of bleeding do not have any more problems than other premature babies who did not have IVH.

Only time will tell to what extent a child's brain is injured and what long-term problems he or she will have.

Follow Up Care for IVH

Children who have had IVH need to be observed and evaluated for several years to check if the bleeding has hurt the brain. Their developmental progress should be tested regularly. If problems develop, special therapy and education programs can begin. These programs will help the child do his or her very best.

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