Periventricular Hemorrhage-Intraventricular Hemorrhage Workup
- Author: David J Annibale, MD; Chief Editor: Ted Rosenkrantz, MD more...
Grade III-IV PVH-IVH has been associated with abnormally high (odds ratio [OR], 1.2.931 [1.825-4.707]) or, to a lesser degree, low (OR, 1.24 [1.036-1.484]) lymphocyte counts, based on reference ranges the authors defined. While nondiagnostic for PVH-IVH, abnormalities might lead to further evaluation.
The following studies are indicated in patients at risk for periventricular hemorrhage–intraventricular hemorrhage (PVH-IVH) and those who have PVH-IVH:
- Cranial ultrasonography
- Ultrasonography is the diagnostic tool of choice for screening examination and follow-up of individuals with PVH-IVH. Current recommendations by the Quality Standards Subcommittee of the American Academy of Neurology suggest that all infants younger than 30 weeks' gestation be screened by cranial ultrasonography at 7-14 days postnatal life and at 36-40 weeks postmenstrual age.
- Ultrasonography is also the diagnostic tool of choice for the follow-up of individuals with PVH-IVH and posthemorrhagic hydrocephalus, as shown below. Serial ultrasonography is indicated weekly to follow for progression of hemorrhage and the development of posthemorrhagic hydrocephalus.
- Normal neonatal brain images are shown below.
- CT scan
- Prior to the availability of ultrasonography, CT scanning was used for diagnosis and follow-up.
- CT scanning is no longer used for diagnosis and follow-up in view of the safety and cost effectiveness of sonography.
- MRI: The use of MRI to diagnose associated white mater injury (periventricular leukomalacia [PVL] is evolving.
See the list below:
- Although not as useful as ultrasonography, frontal-occipital circumference can be used as an adjunct tool in monitoring the progression of posthemorrhagic hydrocephalus.
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