Diagnostic ultrasound ( PDFDrive )

1542 PART V Pediatric Sonography
SEH
Normal
SEH
IVH
Cyst
SEH
IVH
IPH
PC
HC
FIG. 45.35 Sequelae of Subependymal Hemorrhage (SEH). SEH may resolve, leaving a normal scan; may resolve, leaving a small subependymal
cyst; or may progress, rupturing into the ventricle, causing intraventricular hemorrhage (IVH), or extending into the parenchyma, causing intraparenchymal
hemorrhage (IPH). Hydrocephalus (HC) and porencephaly (PC) are common sequelae of SEH. (With permission from Rumack CM,
Manco-Johnson ML. Perinatal and infant brain imaging: role of ultrasound and computed tomography. St Louis: Mosby; 1984. 7 )
manifest as subependymal hemorrhage (SEH), IVH, or IPH 100
(Fig. 45.35). he germinal matrix is a ine network of blood
vessels and primitive neural tissue that lines the ventricular system
in the subependymal layer during fetal life. As the fetus matures,
the germinal matrix regresses toward the foramen of Monro so
that, by full term, only a small amount of germinal matrix is
present in the caudothalamic groove between the thalamus and
the caudate nucleus. his ine network of blood vessels is highly
susceptible to pressure and metabolic changes, which can lead
to rupture of the vessels. he germinal matrix is rarely a site of
hemorrhage ater 32 weeks’ gestation because it has almost disappeared.
hus full-term infants rarely experience this type of
hemorrhage.
he classiication of GMH most widely used was proposed
by Burstein and colleagues. 100 Other systems are used as well,
but the anatomic description of exactly where the brain damage