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Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Germinal matrix haemorrhage occurs in premature infants; after around 36 weeks gestation the germinal matrix is no longer present. It is frequently detected on neonatal cranial ultrasound as hyperechoic areas in the caudothalamic groove adjacent to the ventricles. Germinal matrix haemorrhage is graded I to IV in severity. Grade I is limited to the caudothalamic groove, grade II is intraventricular extension without hydrocephalus, grade III is intraventricular extension with ventricular dilatation and grade IV is parenchymal involvement, which is associated with high mortality.
Intracranial Hemorrhage (ICH)
Published in Swati Goyal, Neuroradiology, 2020
The germinal matrix is a region of thin-walled veins and actively proliferating cells in the sub-ependymal layer of the lateral ventricles. It usually involutes by 34–36 weeks of gestation and has entirely migrated by 40 weeks. GMH is the most common lesion in high-risk low-birth-weight infants, due to hypoxic-ischemic injury to the deep vascular watershed zone in the developing fetus.
The Epidemiology Of Germinal Matrix/ Intraventricular Hemorrhage *
Published in Michele Kiely, Reproductive and Perinatal Epidemiology, 2019
Nigel Paneth, Jennifer Pinto-Martin
Germinal matrix tissue is primarily situated in the basal ganglia (in the head of the caudate nucleus) an area of high blood flow in the premature infant. However, since the area will involute, and its blood supply diminish, the vasculature of the germinal matrix, though abundant, is thin-walled and friable, and lacks mesenchymal support. It is easily ruptured by transmural pressure gradients. It is this combination of high flow and delicate vasculature that makes the germinal matrix so susceptible to bleeding.
Alterations in motor functional connectivity in Neonatal Hypoxic Ischemic Encephalopathy
Published in Brain Injury, 2022
Li Jiang, Dina El-Metwally, Chandler Sours Rhodes, Jiachen Zhuo, Ranyah Almardawi, Alexandre E Medina, Li Wang, Rao P. Gullapalli, Prashant Raghavan
Four out of 16 neonates in the HIE group and 0/11 neonates in the control group demonstrated abnormalities on conventional MRI. A summary of structural abnormalities is shown in Table 2. Of the four neonates with abnormal MRI scans, 3 neonates demonstrated signal abnormalities in the posterior limbs of the internal capsules. Abnormalities of the basal ganglia and thalami were present in three. Abnormalities of the cerebral cortex were present in two. No significant white matter abnormalities were noted. One neonate demonstrated a small area of grade 1 germinal matrix hemorrhage bilaterally. No structural abnormalities were present on conventional MR images of the control group.
Intraperitoneal cannabidiol attenuates neonatal germinal matrix hemorrhage-induced neuroinflamation and perilesional apoptosis
Published in Neurological Research, 2019
Timóteo Abrantes De Lacerda Almeida, Marcelo Volpon Santos, Luiza Da Silva Lopes, Gunjan Goel, Renato Leonardo De Freitas, Priscila De Medeiros, José Alexandre Crippa, Hélio Rubens Machado
The incidence of germinal matrix hemorrhage (GMH) is approximately 3.5 per 1,000 live births and has remained stable in the past 20 years, after a reduction of approximately 50% in the 1980’s[1]. GMH occurs in approximately 45% of preterm infants weighing between 500 and 700 g [2]. It is well known that the pathogenesis of germinal matrix hemorrhage is intrinsically related to prematurity. The pathogenesis of GMH lies in the immaturity of vessels of the subependymal region at the head of the caudate nucleus, as well as disorders of local blood flow, and changes in the coagulation cascade and platelet activity [3].
Oral drugs used to treat persistent pulmonary hypertension of the newborn
Published in Expert Review of Clinical Pharmacology, 2020
Wei Zhang, Yue-E Wu, Xiao-Yan Yang, Jing Shi, John van den Anker, Lin-Lin Song, Wei Zhao
Eye disorder is another ADE worth noticing. Sildenafil is a highly selective PDE-5 inhibitor, but it also affects PDE-6 receptors, which regulate rod and cone photoreceptors [97]. Thus, sildenafil may disturb the visual transduction cascade and lead to retinopathy in premature neonates treated with sildenafil [98]. Moreover, different from the adults and older children, the fragile germinal matrix blood vessels and the lower autoregulatory capacity of the cerebral vessels in the brain of ill infants increase the risk to develop an intracranial bleeding [45,99].