Germinal Matrix Hemorrhage Germinal matrix hemorrhages are the most common type of intracranial hemorrhage in neonates. They generally originate in the subependymal region, but may progress to intraventricular and even intraparenchymal hemorrhage if bleeding continues. Most cases occur in premature infants within the first week of life. The condition is a significant cause of morbidity and mortality in this population. Germinal matrix must be present in order for germinal matrix hemorrhage to occur. Therefore premature infants, generally less than thirty-five weeks gestation, are the only ones affected by this pathology. Germinal matrix hemorrhages can be identified in approximately sixty-seven percent of infants born at twenty-eight to thirty-two…show more content… Significant stress of a premature infant after birth can cause the vessels to rupture. Significant stressors capable of causing germinal matrix hemorrhage include respiratory distress syndrome, dehydration, rapid volume increase, and distress during delivery. There are a number of risk factors associated with the development of germinal matrix hemorrhage. Prenatal risk factors include chorioamnionitis and maternal drug therapy. Neonatal risk factors include prematurity, FINISH. Risk factors include low birth weight, cyanotic congenital heart disease, prolonged labor, and multifetal pregnancy. There are three different presentations associated with germinal matrix hemorrhage. The most common is a “silent” presentation, in which the patient presents with no symptoms. In this case, the pathology is detected on routine sonographic screening. This occurs in approximately 25-50% of cases. SECOND. The least common presentation is catastrophic deterioration. Signs include stupor or coma; irregular respirations, hypoventilation, or apnea; decerebrate posturing; generalized seizures; flaccid weakness; cranial nerve abnormalities, including pupils fixed to light; and bulging of the