Serial sonographic monitoring of intracranial hemorrhage (ICH) and its sequelae in the preterm neonate.

This study documents changes in ventricular size and brain parenchyma that occurred in 41 preterm neonates that had intracranial hemorrhage, out of 136 preterm neonates that were serially examined. Serial real-time sonographic examinations disclosed a close relationship between the severity of ICH and the development of progressive ventricular dilatation. Eighty percent of preterm neonates with minor degrees of ICH [localized subependymal hemorrhage (SEH) or SEH with small intraventricular hemorrhage (SEH/IVH)] did not develop significant ventricular dilatation, whereas all of the neonates with IVH and/or intraparenchymal hemorrhage (IPH) developed moderate or severe ventricular dilatation. Spontaneous resolution of moderate and/or severe ventricular dilatation did occur by the end of the third week of life in approximately one third of neonates with ICH. The therapeutic implications of the findings are discussed.