CNS Pathology - GMH

Question 1

What is the germinal matrix?

Answer 1

The germinal matrix is the site of proliferating neuronal and glial precursors in the developing brain, which is located above the caudate nucleus, in the floor of the lateral ventricle, and caudothalamic groove.

Question 2

How is germinal matrix hemorrhage graded?

Answer 2

grade I : confined to the germinal matrix
grade II : intraventricular hemorrhage without ventricular dilatatation
grade III : intraventricular hemorrhage with ventricular dilatation
gade IV : GMH with intraventricular rupture and hemorrhage into the surrounding white matter

Question 3

What is the pathophysiology of germinal matrix hemorrhage?

Answer 3

The microcirculation in this particular area is extremely sensitive to hypoxia and changes in perfusion pressure. It is most frequent before 35 weeks gestation and is typically seen in very low birth-weight (<1500g) premature infants,because they lack the ability for auto regulation of cerebral blood flow. Consequently increased arterial blood pressure in these blood vessels leads to rupture and hemorrhage into germinal matrix.