Is arterial hypertension crucial for the development of cerebral haemorrhage in premature infants?
Lou, H.C.; Lassen, N.A.; Friis-Hansen, B.
Lancet 1(8128): 1215-1217
1979
ISSN/ISBN: 0140-6736 PMID: 87680 Document Number: 151177
Computerized tomography revealed that more than 40% of premature neonates (birth-wt < 1500 g) have cerebral hemorrhage in the first 3 or 4 days of post natal life. Studies at necropsy showed that hemorrhage usually originates in the capillaries of the germinal matrix. Premature neonates may be hypertensive when their blood-pressure is compared with that in utero and events that lead to further rises in pressure are common. Capillaries are not protected against rises in arterial pressure because autoregulation is impaired. The capillaries in the germinal matrix are not supported by firm glial structures. Arterial pressure rises are apparently responsible for germinal matrix hemorrhage in the premature neonate, and the risk of hemorrhage probably diminishes as autoregulation of cerebral blood-flow is fully developed a few days after birth.