Classification of germinal matrix hemorrhage
The germinal matrix lies in the caudothalamic groove. This is a highly vascular region of the prenatal and premature brain and is prone to hemorrhage, with rupture of the thin venules subsequent to decreased perfusion or oxygenation. Morbidity and mortality may be predicted based on the grade of the hemorrhage:
- • Grade I hemorrhage is confined to the germinal matrix.
- • Grade II hemorrhage extends into the adjacent lateral ventricle.
- • Grade III hemorrhage expands into and dilates the adjacent lateral ventricle.
- • Grade IV hemorrhage is in the adjacent parenchyma, probably due to hemorrhagic venous infarction.
US of the premature infant’s head through the anterior fontanelle is the imaging modality of choice for the diagnosis and follow-up of germinal matrix hemorrhage.