Cranial Sonography (CUS) Instruction Manual
Intraventricular Hemorrhage (IVH) is diagnosed and categorized by previously published Papile and Volpe criteria.
- Grade I IVH, hemorrhage is confined to the germinal matrix.
- Grade II IVH, hemorrhage is present in a no distended lateral ventricle, and fills less than 50% of the ventricular parasagittal diameter
- Grade III IVH is present in a distended lateral ventricle and fills greater than 50% of the lateral ventricle.
- Grade 4 IVH Periventricular hemorrhagic infarction) when a hemorrhagic lesion is seen in the periventricular white matter. Lesions may be unilateral or bilateral. When bilateral, they typically are asymmetric. It is always associated with an ipsilateral IVH. When IVH is bilateral, it usually is larger on the side ipsilateral to the PVHI
Locations for US diagnosis in IVH-4 /hyperechogenicity/Cysts (Parasagittal view):
![](data:image/png;base64,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)
Midline shift:
![](data:image/png;base64,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)
Focal Intraparenchymal Cyst:
Focal Intraparenchymal Cyst: appears on US as a large, generally single and unilateral porencephalic cyst, occurring as a sequela (evolution) of intraparencymal grade 4 IVH (periventricular hemorrhagic infarction). The large cyst often but not invariably communicates with the lateral ventricle.
Cystic periventricular leukomalacia (PVL) :
Cystic Periventriculr Leukomalacia appears on US as echolucencies (cysts) in the periventricular white matter dorsolateral to the lateral ventricles, usually bilateral and symmetrical. Although PVL may be sometimes associated with IVH or PHH, it is not a direct evolution of a intraparenchymal periventricular hemorrhagic infarction (grade 4 IVH).