Recovery of the brain after intraventricular hemorrhage

Intraventricular hemorrhage (IVH) remains a major complication of prematurity, worldwide. The severity of IVH is variable, ranging from a tiny germinal matrix bleed to a moderate-to-large ventricular hemorrhage or periventricular hemorrhagic infarction. Survivors with IVH often suffer from hydroceph...

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Bibliographic Details
Published in:Seminars in fetal & neonatal medicine 2022-02, Vol.27 (1), p.101224-101224, Article 101224
Main Authors: Cheng, Bokun, Ballabh, Praveen
Format: Article
Language:English
Subjects:
Animals
Brain
Brain Injuries - complications
Cerebral Hemorrhage - complications
Cerebral Ventricles
Humans
Hydrocephalus - complications
Infant, Newborn
Infant, Premature, Diseases
Inflammation
intraventricular hemorrhage
Oligodendrocyte progenitor cells
Oxidative stress
Post-hemorrhagic hydrocephalus
Stem cells
White matter injury
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Summary:Intraventricular hemorrhage (IVH) remains a major complication of prematurity, worldwide. The severity of IVH is variable, ranging from a tiny germinal matrix bleed to a moderate-to-large ventricular hemorrhage or periventricular hemorrhagic infarction. Survivors with IVH often suffer from hydrocephalus and white matter injury. There is no tangible treatment to prevent post-hemorrhagic cerebral palsy, cognitive deficits, or hydrocephalus in these infants. White matter injury is attributed to blood-induced damage to axons and maturing oligodendrocyte precursors, resulting in reduced myelination and axonal loss. Hydrocephalus results from obstructed CSF circulation by blood clots, increased CSF production, and reduced CSF absorption by lymphatics and arachnoid villi. Several strategies to promote neurological recovery have shown promise in animal models, including the elimination of blood and blood products, alleviating cerebral inflammation and oxidative stress, as well as promoting survival and maturation of oligodendrocyte precursors. The present review integrates novel mechanisms of brain injury in IVH and the imminent therapies to alleviate post-hemorrhagic white matter injury and hydrocephalus in the survivors with IVH.
ISSN:1744-165X
1878-0946
DOI:10.1016/j.siny.2021.101224