Figure 5.

Grade III GMH-IVH + PVHI. Ultrasound scan in a preterm infant (GA 24 weeks) with bilateral GMH-IVH and left-sided PVHI. (A) Coronal scan 2 days after birth showing a left-sided grade III GMH-IVH (arrowhead, AHW = 7 mm, measurement not shown) and large echodensity in the left frontoparietal white matter (arrow). Smaller right-sided grade II GMH-IVH (arrowhead, AHW = 4 mm, measurement not shown). (B) Left parasagittal scan showing the periventricular echodensity (arrows) extending from the posterior frontal white matter to the parietal white matter. (C) Follow-up coronal scan 2 weeks after birth shows the area of PVHI beginning to develop central echolucency, indicating early cystic degeneration. (D) Follow-up coronal scan 7 weeks after birth shows further cystic degeneration following the PVHI with echogenic clot debris, dilated lateral ventricles, and echogenic ependymal lining. (E,F) Follow-up coronal and left parasagittal scans at 12 weeks show the large porencephalic cyst communicating with the lateral ventricle. Internal clot debris has cleared and ependyma is no longer echogenic. The persisting ventriculomegaly is now partially passive (i.e., ex-vacuo) in origin. In this example, the independent recording of the bilateral GMH-IVH patterns on the baseline cUS exam is recommended.