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Papile · Pediatria
Sistemas/Pediatria

Papile grading of germinal matrix and intraventricular hemorrhage

vigente

Grades germinal matrix and intraventricular hemorrhage in neonates.

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Escala de categorias
IIIIIIIV

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Procedência e vigência

Órgão emissor
Neonatal imaging consensus
Versão
1978
Ano
1978
Família
léxico
Tipo de lógica
flat
Modalidade
US
Fonte primária
Incidence and evolution of subependymal and intraventricular hemorrhage (Papile) · doi:10.1016/s0022-3476(78)80282-0
Última verificação
2026-06-26
Última checagem
2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)
{
  "categories": [
    "I",
    "II",
    "III",
    "IV"
  ]
}

Categorias num relance

Cat.SignificadoCondutaRiscoFonte
I
Grade I
Hemorrhage limited to the germinal matrix (subependymal), without extension into the ventricle.		Supportive neonatal care; serial cranial ultrasound surveillance is advised (roughly weekly for about four weeks and again at discharge) with head-circumference monitoring; no CSF diversion needed in the absence of ventricular dilatation.Low-grade injury but not benign: cerebral palsy reported in roughly 7-8% at 2 years corrected age, and neurodevelopmental delay, hearing loss and CP can still occur.
okfonte
Criteria: StatPearls NBK538310, Introduction. Management/risk: Inan/Karadag review (PMC7536465) — CP ~6.8% in grade I, weekly US surveillance for grades I-II.
II
Grade II
Intraventricular hemorrhage occupying less than 50% of the ventricular area, without ventricular dilatation.		Supportive care with serial cranial ultrasound (about weekly for four weeks and at discharge) and head-circumference tracking; intervention reserved for any progressive ventricular dilatation.Cerebral palsy reported in about 8% at 2 years, rising to ~12% when accompanied by ventricular dilatation or cystic/echodense periventricular leukomalacia.
okfonte
Criteria: StatPearls NBK538310, Introduction. Management/risk: PMC7536465 — CP ~8.1% (12.2% with ventricular dilatation/PVL); weekly US surveillance for grades I-II.
III
Grade III
Intraventricular hemorrhage with ventricular dilatation, the blood occupying more than 50% of the ventricle.		Closer cranial ultrasound surveillance (about twice weekly until discharge); for progressive post-hemorrhagic ventricular dilatation, temporizing CSF measures (ventricular reservoir or ventriculosubgaleal shunt) precede permanent ventriculoperitoneal shunting once the infant reaches ~2-2.5 kg.Severe (grade III/IV) IVH: post-hemorrhagic hydrocephalus develops in roughly a third of very-low-birth-weight infants with IVH; cerebral palsy exceeds 50% and ~75% need special education in grade III-IV.
okfonte
Criteria: StatPearls NBK538310, Introduction. Management/risk: PMC7536465 — twice-weekly US, reservoir/subgaleal shunt then VP shunt; PHH in ~1/3, CP >50% and special education ~75% in grade III-IV.
IV
Grade IV
Intraventricular hemorrhage accompanied by intraparenchymal (periventricular) hemorrhage; previously termed Grade IV, now also called periventricular hemorrhagic infarction (PVHI).		Intensive cranial ultrasound surveillance (about twice weekly until discharge); progressive PHVD managed with temporizing CSF drainage (reservoir/ventriculosubgaleal shunt) and later permanent VP shunting; supportive care with seizure management.Worst prognosis: roughly 30-40% die; severe neurodevelopmental disorder in ~55% (rising to ~86% with PVHI plus shunt); reported cerebral palsy ~60%, cognitive problems ~50%, visual field defects ~25%, epilepsy ~20%.
okfonte
Criteria: StatPearls NBK538310, Introduction. Management/risk: PMC7536465 — mortality ~30-40%, severe NDD ~55% (86% with PVHI+shunt), CP ~60%, cognitive ~50%, visual defects ~25%, epilepsy ~20%.

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