Germinal matrix hemorrhage is a serious condition that can occur in premature babies due to fragile blood vessels in the brain. It can cause brain damage and long-term complications. Treatment involves supporting the child and preventing future hemorrhages. Prevention is key.
Germinal matrix hemorrhage is bleeding that occurs within the brain of a premature baby. The germinal matrix is an area of the brain that contains many blood vessels. Babies born prematurely may not be able to properly regulate blood flow to the brain, so changes in pressure can occur that cause germinal matrix blood vessels to burst. Bleeding can damage brain tissue, leading to complications such as seizures, abnormal mental development, and the neurological condition known as cerebral palsy. The outlook following a germinal matrix hemorrhage depends on the severity of the hemorrhage and the weight and age of the child.
A germinal matrix hemorrhage is the most potentially serious condition that can affect babies born prematurely. Term infants are less at risk because the germinal matrix usually disappears around 36 weeks of age. The arteries within the germinal matrix of premature babies are fragile and this makes them more prone to rupture.
Normally, blood flow through the brain is controlled by small, muscle-walled arteries. Smooth muscle within the walls of arteries can relax or contract to keep blood pressure in the brain constant even as pressure can change in circulation throughout the rest of the body. In some premature infants, this ability to regulate blood flow is lost and germinal matrix hemorrhage may occur.
The germinal matrix is an important site for brain development because nerve cells, or neurons, are produced there and form areas such as the cortex or gray matter. That’s why, even in those children who survive a germinal matrix hemorrhage, damage to this area can sometimes cause long-term problems. Hemorrhages are generally divided into four different grades, with grade I being the mildest and grade IV being the most severe. While only a small percentage of children die from milder grade hemorrhages, up to half of those with grade IV germinal matrix hemorrhage do not survive.
Treatment of germinal matrix hemorrhage involves supporting your child as much as possible and may involve medical attention to correct blood imbalances and maintain blood pressure. Sometimes, a condition known as hydrocephalus develops, in which fluid builds up inside the skull and surgical procedures may be needed to drain it. Since there is no cure, prevention of germinal matrix hemorrhage is very important. Preventive measures may include avoiding breathing problems at birth as much as possible, correcting blood abnormalities, and protecting the baby from large changes in blood pressure.
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