Germinal matrix hemorrhage (grade 1) Germinal matrix hemorrhage (GMH), also known as
periventricular hemorrhage
or preterm caudothalamic hemorrhage occur in the highly vascular but also stress sensitive germinal matrix, located in the caudothalamic groove.
What is a germinal matrix hemorrhage?
Germinal matrix hemorrhages, also known as periventricular-intraventricular hemorrhages (PVIH), are
the commonest type of intracranial hemorrhage in neonates
and are related to perinatal stress affecting the highly vascularized subependymal germinal matrix.
What is a Grade 1 germinal matrix hemorrhage?
Grade 1:
Hemorrhage that is confined to the germinal matrix
. Grade 2: Extension of the hemorrhage into the lateral ventricles without hydrocephalus. Grade 3: Ventricular hemorrhage with the presence of associated hydrocephalus.
What is a grade 1 hemorrhage?
These are called “grades” and are based on the degree of bleeding. Grades 1 and 2 involve a smaller amount of bleeding. Most of the time, there are no long-term problems as a result of the bleeding. Grade 1 is also referred to as
germinal matrix hemorrhage (GMH)
. Grades 3 and 4 involve more severe bleeding.
What does the germinal matrix do?
The germinal matrix is the
area in the developing fetal brain that gives rise to the neuronal cells which will later constitute the grey matter of the brain
.
Do all Grade 4 brain bleeds lead to cerebral palsy?
Grades 1 and 2 do not typically cause complications. Grades 3 and
4 are the most serious
and may result in long-term brain injury or an intraventricular hemorrhage causing cerebral palsy.
Where is the germinal matrix located?
The germinal matrix, located
on the head of caudate nucleus and underneath ventricular ependyma
, is a highly vascular collection of glial and neuronal precursor cells (Fig 1A, B). This periventricular region is selectively vulnerable to hemorrhage in premature infants predominantly in the first 48 h of life.
Which type of intracranial haemorrhage is most common in premature infants?
Intraventricular haemorrhage (IVH)
is the most common type of intracranial haemorrhage in the neonate. It occurs primarily in preterm infants but is occasionally seen in near term and term infants.
How common is IVH in preemies?
Intraventricular hemorrhage (IVH) affects
15–20 % of babies born before 32 weeks of pregnancy
. A lot of risk factors of developing IVH are known.
Why do premature babies have bleeding in the brain?
What causes IVH? A preterm baby’s brain has many tiny, fragile blood vessels. After birth, the premature baby’s brain is
exposed to changes in blood flow and oxygen levels
. This may cause the blood vessels to break and bleeding to occur.
What are 3 types of hemorrhage?
There are three main types of bleeding:
arterial, venous, and capillary bleeding
. These get their names from the blood vessel that the blood comes from. Additionally, bleeding can be either external, such as what comes from a minor skin scrape, or internal, such as what comes from an injury to an organ or bone.
Does IVH go away?
First, IVH may affect the flow of CSF in the ventricles and second, IVH may cause damage to brain tissue adjacent to the ventricles. Once damage has occurred
to brain tissue, it cannot be reversed
. However, physical damage to brain tissue does not necessarily mean damage to brain function.
Can a small brain bleed heal itself?
Many hemorrhages do not need treatment and go away on their own
. If a patient is exhibiting symptoms or has just had a brain injury, a medical professional may order a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan to check for brain hemorrhages.
When does germinal matrix go away?
The pathogenesis of GMH-IVH and PHI is multifactorial and complex. Gestational age is the most important single independent risk factor. The germinal matrix reaches its maximum volume around 25 weeks gestation and subsequently withers. A residual mass persists until
~36 weeks gestational age
.
What does the nail matrix contain?
The matrix, sometimes called the matrix unguis, teratogenous membrane, nail matrix, or onychostroma, is the tissue (or germinal matrix) which the nail protects. It is the part of the nail bed that is beneath the nail and contains
nerves, lymph and blood vessels
. The matrix produces cells that become the nail plate.
How do you know if your nail matrix is damaged?
When this occurs,
a scarred or abnormal nail plate can develop
, or the nail can be lost permanently. Finally, a brown or black line in the nail plate that grows from the cuticle outwards can indicate a matrix problem.
