Germinal Matrix Hemorrhage - Pathophysiology

Pathophysiology

The germinal matrix is the site of proliferation 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. The germinal matrix contains a rich network of fragile thin-walled blood vessels. Hence 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.