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Theodore W. Eller and Joseph F. Pasternak

I n the past decade major advances in neonatal intensive care have allowed the survival of a large number of low birth-weight premature infants. Intraventricular hemorrhage (IVH) arising from the area of the germinal matrix is frequently associated with prematurity. 1, 15 Panventricular enlargement will occur in about half of those children with IVH. 14 This may be a transient phenomenon, not requiring treatment, or there may be progressive signs and symptoms of hydrocephalus. The incidence of post-hemorrhagic hydrocephalus that eventually requires

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Intraventricular hemorrhage from ruptured aneurysm

Retrospective analysis of 91 cases

Gerard Mohr, Gary Ferguson, Moe Khan, David Malloy, Reginald Watts, Brien Benoit and Bryce Weir

T he occurrence of intraventricular hemorrhage (IVH) from any source has historically been viewed as being a grave prognostic indicator. There has been little systematic study of this phenomenon as it relates to aneurysm rupture. The use of computerized tomography (CT) scanning readily permits a definitive diagnosis, so that an attempt at clinicoradiological correlation of these two events appeared worthwhile. An important practical question is whether or not drainage of the ventricular system in such cases is helpful and, if so, how and when. Clinical

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David M. Coulter, Tim LaPine and W. Manford Gooch III

L orenzo , et al. , 6 recently described spontaneous germinal matrix and intraventricular hemorrhage (IVH) in rabbit pups delivered by Caesarean section 3 to 5 days before term. Bleeding occurred in 12.5% of the animals studied. Hemorrhage ranged in severity from mild (germinal matrix only) to massive hemorrhages which filled the ventricular system. Most of these hemorrhages were grossly apparent when the brains were removed at sacrifice. The microscopic pathology was strikingly similar to the hemorrhages reported in premature human infants. This model of IVH

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Laura R. Ment, William B. Stewart, Charles C. Duncan and Richard Lambrecht

evaluation of etiopathogenesis. Pediatrics 66: 42–49, 1980 5. Emerson P Fujimura M Howat P , et al : Timing of intraventricular hemorrhage. Arch Dis Child 52 : 183 – 187 , 1977 Emerson P, Fujimura M, Howat P, et al: Timing of intraventricular hemorrhage. Arch Dis Child 52: 183–187, 1977 6. Fujimura M Salisbury DM Robinson RO , et al : Clinical events relating to intraventricular haemorrhage in the newborn. Arch Dis Child 54 : 409 – 414 , 1979 Fujimura M, Salisbury DM

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Francisco Cordobés, Marina de la Fuente, Ramiro D. Lobato, Ricardo Roger, Carlos Pérez, Jose M. Millán, Alejandro Bárcena and Eduardo Lamas

IVH related to final outcome * Final Outcome +25 to +45 HU +45 to +80 HU Both Densities good recovery 1 moderately disabled 1 1 2 severely disabled 1 vegetative 1 dead 7 12 4 * Abbreviations: IVH = intraventricular hemorrhage; HU = Hounsfield units. TABLE 2 Location of bleeding in 30 patients with posttraumatic IVH related to final outcome * Location of Hemorrhage Good Recovery Moderate Disability Severe Disability

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Beagle puppy model of intraventricular hemorrhage

Effect of superoxide dismutase on cerebral blood flow and prostaglandins

Laura R. Ment, William B. Stewart and Charles C. Duncan

in premature babies. Br Med J 287 : 81 – 84 , 1983 Chiswick ML, Johnson M, Woodhall C, et al: Protective effect of vitamin E (DL-alpha-tocopherol) against intraventricular haemorrhage in premature babies. Br Med J 287: 81–84, 1983 7. Chiswick ML , Wynn J , Toner N : Vitamin E and intraventricular hemorrhage in the newborn. Ann NY Acad Sci 393 : 109 – 120 , 1982 Chiswick ML, Wynn J, Toner N: Vitamin E and intraventricular hemorrhage in the newborn. Ann NY Acad Sci 393: 109–120, 1982 8

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Beagle puppy model of intraventricular hemorrhage

Effect of indomethacin on cerebral blood flow

Laura R. Ment, William B. Stewart, Charles C. Duncan, David T. Scott and Richard Lambrecht

intraventricular hemorrhage. J Neurosurg 57: 219–223, 1982 38. Ment LR , Stewart WB , Scott DT , et al : Beagle puppy model of intraventricular hemorrhage: Randomized indomethacin prevention trial. Neurology 33 : 179 – 184 , 1983 Ment LR, Stewart WB, Scott DT, et al: Beagle puppy model of intraventricular hemorrhage: Randomized indomethacin prevention trial. Neurology 33: 179–184, 1983 39. Milligan DWA : Failure of autoregulation and intraventricular haemorrhage in preterm infants. Lancet 1 : 896

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Beagle puppy model of intraventricular hemorrhage

Effect of indomethacin on local cerebral glucose utilization

Laura R. Ment, William B. Stewart, Charles C. Duncan, David T. Scott and Richard Lambrecht

pretreated with either indomethacin or saline, all of which underwent the hemorrhagic hypotension/volume reexpansion model for intraventricular hemorrhage. Local Cerebral Glucose Utilization Data The 14 C-2DG concentrations as representative of LCGU are found in Table 3 . Concentrations of 2DG in the cortical regions of the I-I, S-I, I-NI, S-NI pups were 0.318, 0.302, 0.271, and 0.251 µ Ci/gm, respectively. Employing an analysis of variance, the indomethacin was found to have no effect on the LCGU of the pups treated with this drug; however, as we have

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E. Scott Conner, Antonio V. Lorenzo, Keasley Welch and Brent Dorval

: 605–608, 1976 13. Hambleton G , Wigglesworth JS : Origin of intraventricular haemorrhage in the preterm infant. Arch Dis Child 51 : 651 – 659 , 1976 Hambleton G, Wigglesworth JS: Origin of intraventricular haemorrhage in the preterm infant. Arch Dis Child 51: 651–659, 1976 14. Kenny JD , Garcia-Prats JA , Hilliard JL , et al : Hypercarbia at birth: a possible role in the pathogenesis of intraventricular hemorrhage. Pediatrics 62 : 465 – 467 , 1978 Kenny JD, Garcia-Prats JA

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Jun-Ichiro Hamada, Nobuo Hashimoto and Tetsuya Tsukahara

T he most common clinical manifestation of moyamoya disease in adults is subarachnoid, intracerebral, or intraventricular hemorrhage. The incidence of hemorrhage exceeds 60% in adults presenting with moyamoya disease and is 10% in children. 9 Initially, rupture of the affected vessel was thought to be responsible for such a hemorrhage; recently, however, an associated aneurysm has been considered as a possible source of bleeding. 1, 4 To our knowledge, moyamoya disease with repeated intraventricular hemorrhage due to a peripheral aneurysm has not been