Yang Zhao, Luo Tian Tian, Dai Ya-Lan, Duan Han-Xiao, Chong Cheong-Meng, Tang Jun
Department of Neurosurgery, Children's Hospital of Chongqing Medical University. National Research Center for Child Health and Disorders, Chongqing, 400014, China.
Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, 400014, China.
Curr Neuropharmacol. 2025;23(3):241-255. doi: 10.2174/1570159X23666240906115817.
Germinal matrix-intraventricular hemorrhage (GM-IVH) is a detrimental neurological complication that occurs in preterm infants, especially in babies born before 32 weeks of gestation and in those with a very low birth weight. GM-IVH is defined as a rupture of the immature and fragile capillaries located in the subependymal germinal matrix zone of the preterm infant brain, and it can lead to detrimental neurological sequelae such as posthemorrhagic hydrocephalus (PHH), cerebral palsy, and other cognitive impairments. PHH following GM-IVH is difficult to treat in the clinic, and no levelone strategies have been recommended to pediatric neurosurgeons. Several cellular and molecular mechanisms of PHH following GM-IVH have been studied in animal models, but no effective pharmacological strategies have been used in the clinic. Thus, a comprehensive understanding of molecular mechanisms, potential pharmacological strategies, and surgical management of PHH is urgently needed. The present review presents a synopsis of the pathogenesis, diagnosis, and cellular and molecular mechanisms of PHH following GM-IVH and explores pharmacological strategies and surgical management.
脑室周围-脑室内出血（GM-IVH）是一种发生在早产儿中的有害神经并发症，尤其常见于妊娠32周前出生的婴儿以及极低出生体重儿。GM-IVH的定义为早产儿脑室内室管膜下生发基质区未成熟且脆弱的毛细血管破裂，它可导致有害的神经后遗症，如出血后脑积水（PHH）、脑瘫和其他认知障碍。GM-IVH后的PHH在临床上难以治疗，且尚未向小儿神经外科医生推荐一级治疗策略。在动物模型中已经研究了GM-IVH后PHH的几种细胞和分子机制，但临床上尚未使用有效的药物治疗策略。因此，迫切需要全面了解PHH的分子机制、潜在的药物治疗策略和手术管理。本综述概述了GM-IVH后PHH的发病机制、诊断以及细胞和分子机制，并探讨了药物治疗策略和手术管理。
