Figure 4.

Left-sided grade III GMH-IVH. Ultrasound scan in a preterm infant (GA 25 weeks) showing bilateral IVH. (A) Coronal scan, at the level of the bodies of the lateral ventricles, 2 days after birth shows a large left GMH-IVH (arrow) with intraventricular blood acutely distending its lateral ventricle (AHW = 7 mm, measurement not shown). Note also the enlarged temporal ventricular horns. A small amount of blood in the right lateral ventricle (arrowhead) is present. As there is no clear GMH on the right, it is likely that the blood in the right lateral ventricle has flowed, or re-distributed, from the left-sided GMH-IVH. There is ballooning (rounding) of the right frontal ventricular horn (AHW = 6.5 mm, measurement not shown). (B) Parasagittal view shows that the left grade III GMH-IVH fills >50% of the distended lateral ventricle. (C) Coronal T2-weighted MR image 3 months after birth shows subtle hypointense staining at the left caudothalamic notch from hemosiderin/ferritin (arrowhead). No hypointense signal involves the right germinal matrix region, consistent with the earlier ipsilateral IVH having represented “spill-over.” Widened subarachnoid spaces and persistent ventriculomegaly mostly reflects tissue volume loss.