title: A different view: there is value in grading intraventricular hemorrhage.
abstract: The traditional 1-4 grading system for intra-ventricular haemorrhage (IVH) has been criticized on several points. Grade 1 IVH is not really intra-ventricular at all but all neurosonographers have recognized this for many years. Grade 3 IVH is criticized as it includes ventricular dilatation but grade 3 IVH is a haemorrhage large enough to distend the ventricle with blood not cerebrospinal fluid (CSF). The distinction between small and large IVH is valuable as the prognosis is very different. Grade 4 IVH is criticized as it is not an 'extension' but authors have described this as parenchymal haemorrhagic infarction for decades. Grade 4 IVH has different risk factors, prognosis and prophylaxis from periventricular leucomalacia. The shorthand category of 'severe IVH', meaning grades 3 and 4, is not adequate for individual patient assessment but is certainly useful for annual statistics, comparisons over time and between hospitals.
  
  
  CONCLUSIONS
  Despite limitations, grading IVH has value.
authors: Department of Clinical Science, University of Bristol, Bristol, United Kingdom. Andrew.whitelaw@bristol.ac.uk
authors: Andrew
authors: A
authors: Whitelaw
mesh_terms: D002543:Cerebral Hemorrhage / Q000145:classification* / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology*; D002648:Child; D006801:Humans; D012720:Severity of Illness Index