Serial sonography of posthemorrhagic ventricular dilatation and porencephaly after intracranial hemorrhage in the preterm neonate

Changes in ventricular size and brain parenchyma were documented in 40 preterm neonates with intracranial hemorrhage (ICH), who were serially examined for 3 weeks or more. Sonography disclosed a close relation between the severity of the intracranial hemorrhage and the development of progressive ventricular dilatation. Eighty percent of preterm neonates with minor degrees of intracranial hemorrhage (localized subependymal hemorrhage or subependymal hemorrhage with small intraventricular hemorrhage [subependymal/intraventricular hemorrhage]) did not develop significant ventricular dilatation, whereas all of the neonates with intraventricular and/or intraparenchymal hemorrhage developed moderate or severe ventricular dilatation. Spontaneous resolution of moderate and/or severe ventricular dilatation occurred by the end of the third week in about one-third of neonates with intracranial hemorrhage. Progressive ventricular dilatation was documented in 10 of 15 neonates with major intraventricular and/or intraparenchymal hemorrhage. The therapeutic implications of the findings are discussed.