The Epidemiology Of Germinal Matrix/ Intraventricular Hemorrhage *

Abstract

Germinal matrix/intraventricular hemorrhage (GM/IVH) is the most frequent and clinically significant form of intracranial bleeding in the human neonate. Germinal matrix tissue is primarily situated in the basal ganglia and area of high blood flow in the premature infant. Ventricular hemorrhage can arise from a source other than the germinal matrix. A link between respiratory disease in the infant and the role of the pressure-passive circulation in predisposing to GM/IVH is provided by observations that suggest an association between complications of respiratory illness, sudden increase in systemic blood pressure, and increases in cerebral blood flow velocity. Prematurity and brain bleeding are both pathologic conditions linked to increased risk of subsequent neurologic impairment. Extravasation of blood from a vessel occurs when the difference between intravascular and extravascular pressure, the transmural pressure gradient, exceeds the tensile strength of the vessel wall.