Neonatal periventricular hemorrhage: past, present, and future
Volpe, J.J.
Journal of Pediatrics 92(4): 693-696
1978
ISSN/ISBN: 0022-3476 PMID: 633048 Document Number: 130065
The classical clinical setting for periventricular hemorrhage is a small premature infant that experiences a serious hypoxic event 24-48 h before the ictus. Two clinical syndromes herald the occurrence of the hemorrhage. The 1st is a catastrophic deterioration whch characteristically occurs in the infant who usually does not survive; and the 2nd, a more saltatory deterioration occurs in the infant who usually does survive. The use of computerized axial tomography has resulted in a significant reduction in mortality. Repeated lumbar punctures from the time of the acute hemorrhage serve to lower increased intracranial pressure, a potential cause of brain injury, as well as to remove blood and protein, which may be critical in the genesis of permanent obstructions to CSF flow and absorption. The generally accepted pathogenetic formulations recognize the importance of prematurity and the periventricular locus, and attribute major significance to preceding hypoxic insult(s).