Sajjadian Negar, Fakhrai Hossein, Jahadi Ramin
Department of Neonatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. NSajjadian@ yahoo.com
Acta Med Iran. 2010 Jul-Aug;48(4):260-2.
Germinal matrix-intraventricular hemorrhage (IVH) is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus). Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500 g and gestational age equal or less than 37 weeks) who admitted in Mofid Hospital NICU (Tehran, Iran) during a one year period. For all neonate (including criteria) brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventricular-germinal matrix hemorrhage was seen in 64.4% (35 patients). Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.
生发基质-脑室内出血(IVH)是新生儿颅内出血最常见的类型,是早产儿的特征。该病变的重要性不仅与其高发病率有关,还与其伴随的并发症(如脑积水)有关。脑超声检查是诊断生发基质-脑室内出血和脑积水的首选方法。在本研究中,我们使用脑超声检查来检测脑室内出血和出血后脑积水及其发生率。研究人群包括在伊朗德黑兰莫菲德医院新生儿重症监护病房(NICU)住院的早产儿(出生体重等于或小于1500克,胎龄等于或小于37周),为期一年。对所有新生儿(包括符合标准者)在出生后第一周进行脑超声检查,若存在IVH,则每周进行系列脑超声检查以检测脑积水。共有57名新生儿进入研究。64.4%(35例患者)出现脑室内-生发基质出血。脑室内-生发基质出血患者中,40%为I级,11%为II级,25.7%为III级,2.8%为VI级。在有脑室内-生发基质出血的患者中,20%检测到脑积水。我们研究中的IVH发生率与其他地区和情况相比更高。脑积水与IVH的严重程度直接相关。这表明通过控制IVH的危险因素,我们可以控制出血后脑积水。