Anatomy of the Subependymal veins in the preterm newborns

conseguenze vene subependimali neonati pretermine

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Risk factors and research of Intraventricular Brain Hemorrhages

The intraventricular brain hemorrage and the germinative matrix hemorrage (IVH and GMH) are among the main complications of prematurity with consequences such as death or neurological sequelae.

As of today, different risk factors have been identified, such as: gestational age, absence of steroid treatment, low Apgar score, pneumothorax…

The aim of the research is to confront the anatomy of the cerebral veins in preterm newborns that have experienced a brain bleed to those of a group of preterm babies with a normal MRI brain scan; this would help understand the connection between the anatomy of cerebral veins with the clinical risk factors of IVH-GMH.
The study has demonstrated how specific anatomical features of the subependymal veins (located beneath the ependyma, which is a lining that covers the cerebral ventricles) – among which a narrower bend of these veins – could be an additional and independent risk factor for cerebral hemorrhages (IVH-GMH).

Where does this research bring us?

As with every multifactorial disease, it is very important to know every risk factor to module the treatment in the stages prior the onset of the hemorrhage.

We care about this study because the analysis of the venous system in the area where the germinative matrix  blood flows tells us how, in the event of venous stasis or venous hypertension, those who have a particular anatomy must be made more cautious of changes in refilling of the circulation, therefor providing less fluids or even produce a higher blood fluidity (lowering the hematocrit or at least preventing it from growing, otherwise slightly anticoagulated the help in flow better), since the germinative matrix breaks down because the issue is downstream, in the venous system.
In other words, this hemorrhage originates in the venous stream. Even ventilation modes can affect the venous filling.

What are the possible advances?

The next step will be to better research the features of the venous system immediately after birth thanks to ultrasound studies using color doppler echographer. For this reason, Eu-Brain has bought a particularly advanced echographer to evaluate the flow of the small venous systems flow. A study on the venous anatomy of the subependymal areas is being brought forward to identify, in the first hours of life, the newborns at a higher risk that are otherwise detected after weeks and with an MRI scan. This is to provide an immediate treatment plan for the potential obstruction of the veins that lead to the occurrence of germinative -matrix and intraventricular hemorrhages.

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