title: Risk factors for intraventricular hemorrhage in term asphyxiated newborns treated with hypothermia.
abstract: BACKGROUND
  Intraventricular hemorrhage is rare in term newborns. Severe asphyxia is recognized as one of the risk factors of intraventricular hemorrhage in these newborns. Therapeutic hypothermia, which is the only available treatment for the limitation of brain injury in term asphyxiated newborns, may cause fluctuations of cerebral blood flow, possibly placing the newborn more at risk for intraventricular hemorrhage. The literature regarding the incidence of intraventricular hemorrhage in the context of neonatal hypoxic-ischemic encephalopathy and hypothermia is sparse.
  
  
  METHODS
  We present a clinical observation and review the literature regarding the risk factors for intraventricular hemorrhage in term asphyxiated newborns treated with hypothermia.
  
  
  RESULTS
  We describe the clinical course of a term newborn with severe hypoxic-ischemic encephalopathy who developed significant intraventricular hemorrhage during the rewarming period after the 72-hour hypothermia.
  
  
  CONCLUSIONS
  This newborn presented several risk factors for intraventricular hemorrhage, including severe asphyxia, hemodynamic instability, hemostasis disturbances, instrument delivery, venous sinus thrombosis, and hypoglycemia. Hypothermia and rewarming also may have contributed by causing fluctuations in cerebral blood flow.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Ghalia
authors.initials: G
authors.lastname: Al Yazidi
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Myriam
authors.initials: M
authors.lastname: Srour
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: pia.wintermark@bluemail.ch.
authors.forename: Pia
authors.initials: P
authors.lastname: Wintermark
mesh_terms: D001238:Asphyxia Neonatorum / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D004453:Echoencephalography; D004569:Electroencephalography; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors
keywords: birth asphyxia; hypothermia; hypoxic-ischemic encephalopathy; intraventricular hemorrhage; magnetic resonance imaging; newborn brain