Intraventricular Hemorrhage (IVH) in Infants

IVH is a serious condition caused by bleeding (hemorrhage) in the ventricles. Ventricles are chambers in the brain that hold cerebrospinal fluid (CSF). The fluid circulates from the ventricles into the spinal column. In premature infants, the ventricles are lined with tiny, fragile blood vessels making them more susceptible to IVH. Changes in blood pressure can cause them to bleed. This is IVH. Blood in the ventricles can keep fluid from circulating normally. If IVH occurs, it’s almost always within 5 days after birth.

How is IVH diagnosed and treated?

Ultrasound, a noninvasive imaging test, is used to look at the brain for signs of bleeding. Babies born at less than 32 weeks’ gestation (more than 6 weeks premature) will have a brain ultrasound. If IVH is detected, it is assigned a grade of 1 (mild) to 4 (severe). The grade is based on the amount of bleeding, and whether blood is getting out of the ventricles into the brain tissue. Medicines may be used to decrease the amount of CSF the body produces. Other treatments may be needed if complications develop.

What are the long-term effects?

The outcome depends on how severe the problem is. Many babies have less severe IVH (grade 1 or 2). These babies can vary from having few or no lasting effects to babies with more severe disease having more serious complications. These complications can include neurological damage and developmental delays. Babies with grade 3 IVH may require treatment for hydrocephalus (see below). Grade 4 IVH is very likely to cause hydrocephalus, leading to more serious long-term problems. Your healthcare provider can provide more information on the long term outcome for your baby.