intraventricular hemorrhage
description
this is bleeding within cerebral ventricles. factors predisposing to prenatal haemorrhage include maternal anticoagulation, hypertension, alloimmune thrombocytopenia and premature intrauterine closure of the foramen ovale.
diagnosis
an echogenic area within the ventricles or brain parenchyma is seen in acute intracranial haemorrhage. the site will vary. intraventricular haemorrhage will result in a dilated ventricular system containing echogenic material. there may be distortion of normal intracranial anatomy (midline shift). cystic lesions will be noted if the episode has occurred some time before.
differential diagnosis
intracranial tumours present the main differential diagnosis, as their architecture may appear equally bizarre; however, invasion and progressive enlargement will be likely on serial scans.
sonographic features
hyperechoic areas seen in ventricles if acute.
cystic areas may develop at a later stage.
may be associated hydrocephaly.
associated syndromes
references
sadler lc, lane m, north r severe fetal intracranial haemorrhage during treatment with cholestyramine for intrahepatic cholestasis of pregnancy br j obstet gynecol 102: 169-170
catanzarite va, schrimmer db, maida c, mendoza a prenatal sonographic diagnosis of intracranial haemorrhage: report of a case with a sinusoidal fetal heart rate tracing, and review of the literature prenat diagn 15: 229-235
anderson mw, mcgahan jp sonographic detection of an in utero intracranial hemorrhage in the second trimester j ultrasound med 13: 315-318
dellinger eh, wheeler tc subdural hematoma fetus 4(2): 7728.1
coulson cc, kuller ja, sweeney wj nonimmune hydrops and hydrocephalus secondary to fetal intracranial hemorrhage am j perinatol 11: 253-254
hadi ha, finley j, mallette jq, strickland d prenatal diagnosis of cerebellar hemorrhage: medicolegal implications am j obstet gynecol 170: 1392-1395
achiron r, pinchas oh, reichman b, heyman z, schimmel m, eidelman a fetal intracranial haemorrhage: clinical significance of in utero ultrasonographic diagnosis br j obstet gynaecol 100: 995-999
ville y, jenkins e, shearer mj, hemley h, vasey dp, layton m, nicolaides kh fetal intraventricular haemorrhage and maternal warfarin lancet 341: 1211
demir rh, gleicher n, myers sa atraumatic antepartum subdural hematoma causing fetal death am j obstet gynecol 160: 619-620
donn sm, barr m, mcleary rd massive intracerebral hemorrhage in utero: sonographic appearance and pathologic correlation obstet gynecol 63: 28s
bondurant s, boehm fh, fleischer ac, machin je antepartum diagnosis of fetal intracranial hemorrhage by ultrasound obstet gynecol 63: 25s