Figure 3.

Grade II GMH-IVH. (A–C) Ultrasound scan in a preterm infant (GA 26 weeks) with common pattern of grade II GMH-IVH. (A) Coronal scan at the level of the frontal horns of the lateral ventricles shows echogenic clot involving the caudate nucleus (arrow). No ventricular dilatation. (B) Coronal scan at the level of the trigone of the lateral ventricles shows a small volume of intraventricular clot layering dependently (arrowhead). (C) Parasagittal scan through the right lateral ventricle shows the same clot centered at the caudothalamic notch (arrow) and the intraventricular hemorrhage within the occipital horn separate to choroid plexus (arrowhead). (D–F) Ultrasound scan in a different preterm infant (GA 27 weeks) with delayed pattern of Grade II GMH-IVH. (D) Coronal scan, at the level of the frontal horns of the lateral ventricles, was initially normal 2 days after birth. No GMH-IVH was detected. (E) Follow-up coronal scan 6 days after birth shows echogenic clot in the left lateral ventricle (arrowhead). The AHW is <6 mm (measurement not shown). Normal choroid plexus in the roof of the third ventricle (arrow). (F) Additional coronal view of the frontal horns anterior to the foramen of Monro shows further echogenic intraventricular clot (arrowhead). There is no extension of choroid plexus anteriorly past the caudothalamic grooves (i.e., the frontal and occipital horns have no choroid plexus), thus echogenic material in these sites suggests IVH. This infant had two cUS exams in the first week after birth. The cUS scan showing the greatest severity of GMH-IVH in the first week (i.e., cUS at 6 days after birth in this case) should be considered for GMH-IVH classification purposes.