Fast Five Quiz: Intracranial Hemorrhage

Helmi L. Lutsep, MD


May 01, 2019

Subependymal hemorrhage, which primarily occurs in premature neonates, is divided into four grades. A grade III subependymal hemorrhage corresponds to intraventricular hemorrhage with ventriculomegaly (also referred to as hydrocephalus). A description of the four grades of subependymal hemorrhage is provided in the Table below.

Imaging studies to assess subependymal hemorrhage include CT and MRI. A CT scan taken during the acute phase of subependymal hemorrhage, or an MRI study taken during acute and/or later stages of hemorrhage, help to determine the location and grade of the hemorrhage. CT, which is more commonly used, readily demonstrates acute hemorrhage as hyperdense signal intensity. Multifocal hemorrhages at the frontal, temporal, or occipital poles suggest a traumatic etiology.

Table 1. Grading of Subependymal Hemorrhage

Grade Hemorrhage Location
I Subependymal hemorrhage
II Intraventricular hemorrhage without ventriculomegaly
III Intraventricular hemorrhage with ventriculomegaly
IV Intraventricular hemorrhage with parenchymal hemorrhage

For more on the workup of intracranial hemorrhage, read here.


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