Intraventricular hemorrhage in asphyxiated newborns treated with hypothermia: a look into incidence, timing and risk factors

Table 1 Timing of imaging and seizures in term asphyxiated newborns treated with hypothermia developing intraventricular hemorrhage (IVH)

Patient #	Before or during cooling Day 1 of life	During cooling Days 2–4 of life	During rewarming Day 4 of life	After cooling and rewarming Days 4–6 of life	After cooling and rewarming Days 7–15 of life	Brain injury^a	Other intracranial bleeding
Term asphyxiated newborns treated with hypothermia and developing IVH (n = 15)
Severity of IVH
IVH limited to the choroid plexus vessels in the lateral ventricles or without ventricular dilatation (n = 8)
1				HUS day 4 no IVH	MRI day 7 IVH	None	subdural hematomas
2	HUS day 1 no IVH				MRI day 10 IVH	CGM + WM	subdural hematomas
3		HUS day 3 no IVH			MRI day 10 IVH	None	subdural hematomas
4	HUS day 1 no IVH			MRI day 4 IVH	N/A	CGM + WM	None
5^b	HUS day 1 no IVH	HUS day 2 IVH			N/A	CGM + WM	subdural hematomas
6				MRI day 5 IVH	N/A	None	None
7	MRI day 1 no IVH	MRI day 2 IVH			MRI day 10 IVH	None	subdural hematomas
8					MRI day 14 IVH	None	subdural hematomas
IVH with ventricular dilatation or parenchymal hemorrhage (n = 7)
9^b			seizure	HUS day 4 IVH	N/A	N/A	N/A
10		MRI day 3 no IVH	seizure		MRI day 13 IVH	CGM + WM + BG	subdural + epidural hematoma
11	MRI day 1 IVH	MRI day 2 IVH			MRI day 10 IVH	None	none
12	HUS day 1 no IVH			CT day 5 IVH	MRI day 10 IVH	CGM + WM	None
13		MRI day 3 IVH			MRI day 10 IVH	None	subdural hematomas
14^a	HUS day 1 no IVH	HUS day 2 IVH			N/A	N/A	N/A
15		HUS day 2 no IVH	seizure	MRI day 5 IVH	MRI day 10 IVH	CGM+WM+BG	None

^aEach MRI or autopsy was categorized as brain injury predominantly in the basal ganglia (BG), predominantly in the watershed areas (CGM + WM), or in the cortical grey matter, white matter and basal ganglia (CGM + WM + BG)
^bThese patients died from the complications of neonatal encephalopathy. Patient #5 did not have a brain MRI to define the extent of brain injury, but had an autopsy. Patients #9 and #14 did not have a brain MRI or an autopsy to define the extent of brain injury
Abbreviations: CT computed tomography, HUS head ultrasound, MRI magnetic resonance imaging, CGM cortical grey matter, WM white matter, BG basal ganglia

ISSN: 1471-2431