Prognosis
In infants, germinal matrix haemorrhage is associated with cerebral palsy, problems with cognition, and hydrocephalus. With improved technological advances in science and medicine, survival for preterm infants with this type of neurological disorder has improved and less preterm infants with germinal matrix haemorrhage have severe cerebral palsy. An estimated 15% of preterm infants who survive develop cerebral palsy and 27% of the infants who survive experience moderate to severe neurosensory deficits by the time they reach 18–24 months old.Prognosis is very poor when IVH results from intracerebral hemorrhage related to high blood pressure and is even worse when hydrocephalus follows. It can result in dangerous increases in ICP and can cause potentially fatal brain herniation. Even independently, IVH can cause morbidity and mortality. First, intraventricular blood can lead to a clot in the CSF conduits blocking its flow and leading to obstructive hydrocephalus which may quickly result in increased intracranial pressure and death. Second, the breakdown products from the blood clot may generate an inflammatory response that damages the arachnoid granulations, inhibiting the regular reabsorption of CSF and resulting in permanent communicating hydrocephalus. Associated conditions
Brain contusions and subarachnoid hemorrhages are commonly associated with IVH. The bleeding can involve the anterior communicating artery or the posterior communicating artery. In both adults and infants, IVH can cause dangerous increases in ICP, damage to the brain tissue, and hydrocephalus. Epidemiology
IVH has been reported to occur in approximately 25% of infants who are born with a very low birth weight.
Pre-excitation syndrome is a heart condition in which part of the cardiac ventricles are activated too early. Pre-excitation is caused by an abnormal electrical connection or accessory pathway between or within the cardiac chambers. Pre-excitation may not cause any symptoms but may lead to palpitations caused by abnormal heart rhythms. It is usually diagnosed using an electrocardiogram, but may only be found during an electrophysiological study. The condition may not require any treatment at all, but symptoms can be controlled using medication or catheter ablation. Types
Several types of pre-excitation syndrome have been described. Pathophysiology
Normally, the atria and the ventricles are electrically isolated, and electrical contact between them exists only at the "atrioventricular node". In all pre-excitation syndromes, at least one more conductive pathway is present. Physiologically, the normal electrical depolarization wave is delayed at the atrioventricular node to allow the atria to contract before the ventricles. However, there is no such delay in the abnormal pathway, so the electrical stimulus passes to the ventricle by this tract faster than via normal atrioventricular/bundle of His system, and the ventricles are depolarized (excited) before (pre-) normal conduction system. References


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