The amount of bleeding varies. IVH is often described in four grades:
- Grade I - bleeding occurs just in the germinal matrix.
- Grade II - bleeding also occurs inside the ventricles.
- Grade III - ventricles are enlarged by the blood. (ßAiden’s Grade)
- Grade IV - there is bleeding into the brain tissues around the ventricles.
There has been various therapies employed into preventing the high rates of morbidity and mortality, including diuretic therapy , repeated lumbar puncture , streptokinase therapy  and most recently combination a novel intervention DRIFT (drainage, irrigation and fibrinolytic therapy). DRIFT has been tested in an international randomised clinical trial, although it did not significantly lower the need for shunt surgery, severe cognitive disability at 2 years Bayley (MDI <55) was significantly reduced . Repeated Lumbar punctures is used widely to reduce the effects in increased intracranial pressure and an alternative to ventriculo-shunt (VP) surgery that cannot be preformed incase of intraventricular haemorrhage. The relative risk of repeated lumbar puncture is close to 1.0 therefore it is not statistically when compared to conservative management and does raise the risk of subsequent CSF infection .
Good night friends,