title: Fetal germinal matrix and intraventricular hemorrhage.
abstract: Subependymal germinal matrix with intraventricular hemorrhage (GMIVH) is a common complication associated with delivery in preterm neonates but has rarely been observed in the fetus. Clinical and neuroradiological findings of 5 patients who were diagnosed as having fetal GMIVH with prenatal ultrasonographic examinations (US) and MRI, and postnatal MRI were reviewed retrospectively. During a seemingly uneventful pregnancy, fetal GMIVH occurred at approximately 30-33 weeks of gestation, with the absence of any known factor predisposing to fetal hemorrhage. Routine obstetric US revealed an intraventricular lesion in the enlarged ventricles. Prenatal MRI clearly demonstrated parenchymal change such as intracerebral hematoma adjacent to the subependymal and intraventricular hematoma, and periventricular leukomalacia as well as GMIVH. Although patients without parenchymal destruction (hemosiderin deposit alone) had a favorable neurodevelopmental outcome, encephalomalacia and periventricular leukomalacia contributed to long-term neurodevelopmental deficits. Evaluating parenchymal damage with prenatal MRI can therefore help to predict neurodevelopmental prognosis of the fetus with GMIVH.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. takato@ns.med.kyushu-u.ac.jp
authors.forename: Takato
authors.initials: T
authors.lastname: Morioka
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Hashiguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Futoshi
authors.initials: F
authors.lastname: Mihara
authors.forename: Shunji
authors.initials: S
authors.lastname: Hikino
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Tsukimori
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000196:embryology* / Q000473:pathology; D002552:Cerebral Ventricles / Q000196:embryology* / Q000473:pathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies