Grading of germinal matrix hemorrhage has taken several forms over the years. The most commonly used system is the sonographic grading system proposed by Burstein, Papile, et al.
Classification
grade I
restricted to subependymal region/germinal matrix which is seen in the caudothalamic groove
overall good prognosis 4
3.1% mortality 7
grade II
extension into normal-sized ventricles and typically filling less than 50% of the volume of the ventricle
overall good prognosis 4
7.8% mortality 7
grade III
extensive hemorrhage with distension/dilation of the ventricles
21.3% mortality 7
grade IV
parenchymal involvement
36.1% mortality 7
It was initially postulated that grade IV IVH represented parenchymal extension of ventricular hemorrhage. It is now recognized that grade IV IVH represents parenchymal hemorrhage secondary to venous infarction caused by compression of deep terminal veins by an expanded ventricle filled with blood.
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