Observed pre-intervention and non-intervention ventricular growth trajectories in neonates with severe intraventricular hemorrhage and post-hemorrhagic ventricular dilation.

BACKGROUND: Post-hemorrhagic ventricular dilation (PHVD) after severe intraventricular hemorrhage (SIVH) remains incompletely characterized. OBJECTIVE: To quantify ventricular expansion after SIVH and explore associations with bilateral hemorrhage burden and mortality. METHODS: We retrospectively reviewed 43 neonates with SIVH-associated PHVD cared for in a single NICU from 2010 to 2025. Serial cranial ultrasounds were measured for ventricular index (VI) and anterior horn width (AHW). Post-intervention measurements were censored. An exploratory bilateral hemorrhage-burden score summed maximum right and left IVH grades. RESULTS: VI and AHW increased significantly with PMA, each at 0.105 mm/day. High composite IVH score (7-8) was associated with faster VI and AHW expansion than low score (3-6), and with higher mortality. CONCLUSIONS: Ventricular enlargement progressed approximately linearly during observed pre-intervention/non-intervention follow-up. Bilateral hemorrhage-burden scoring may improve risk stratification, but findings are exploratory.