Case 32: Grade IV Intracranial Hemorrhage

Grade-IV Intracranial Hemorrhage:

Clinical History

• Preterm baby
• Birth asphyxia
• Low birth weight
• Delayed crying/ No crying
• Convulsion

Ultrasound Findings

• Intraventricular bleeding.
• Ventriculomegaly.
• Brain parenchymal extension of hemorrhage

Prognosis/Sequelae

• Poor prognosis
• Posthemorrhgic hydrocephalus
• Loss of brain tissue forming porencephalic cysts
• Developmental retardation
• Neurological deficits

 

Types of Intracranial Hemorrhage

• Grade I: Isolated subependymal hemorrhage
• Grade II: Intraventricular hemorrhage without ventriculomegaly
• Grade III: Intraventricular hemorrhage with ventriculomegaly
• Grade IV: Intraventricular hemorrhage with ventriculomegaly with parenchymal extension

Case 01:

• 32 days old preterm low birth weight baby of an eclampsic mother with no history of crying since birth.
• Ultrasound shows dilated lateral ventricles with clots around the choroid plexus. Intraparenchymal cystic lesion with internal clots are seen indicating intraparenchymal extension turing into porencephalic cysts.