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A different view: there is value in grading intraventricular hemorrhage
Author(s) -
Whitelaw Andrew
Publication year - 2007
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00438.x
Subject(s) - medicine , grading (engineering) , intraventricular hemorrhage , myocardial infarction , ventricle , cardiology , radiology , pediatrics , pregnancy , civil engineering , biology , engineering , genetics , gestational age
The traditional 1–4 grading system for intra‐ventricular haemorrhage (IVH) has been criticized on several points. Grade 1 IVH is not really intra‐ventricular at all but all neurosonographers have recognized this for many years. Grade 3 IVH is criticized as it includes ventricular dilatation but grade 3 IVH is a haemorrhage large enough to distend the ventricle with blood not cerebrospinal fluid (CSF). The distinction between small and large IVH is valuable as the prognosis is very different. Grade 4 IVH is criticized as it is not an ‘extension’ but authors have described this as parenchymal haemorrhagic infarction for decades. Grade 4 IVH has different risk factors, prognosis and prophylaxis from periventricular leucomalacia. The shorthand category of ‘severe IVH’, meaning grades 3 and 4, is not adequate for individual patient assessment but is certainly useful for annual statistics, comparisons over time and between hospitals. Conclusion: Despite limitations, grading IVH has value.