vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v12i6.873vsp-255Research ArticleНЕПРЕРЫВНОЕ ПРОФЕССИОНАЛЬНОЕ ОБРАЗОВАНИЕPROFESSIONAL DEVELOPMENTКЛИНИКО-МОРФОЛОГИЧЕСКАЯ КЛАССИФИКАЦИЯ ВНУТРИЖЕЛУДОЧКОВЫХ КРОВОИЗЛИЯНИЙ В МОЗГCLINICAL AND MORPHOLOGICAL CLASSIFICATION OF CEREBRAL INTRAVENTRICULAR HEMORRHAGESВласюкВ. В.VlasyukV. V.

Vlasyuk Vasiliy Vasilyevich, Doctor of Medical Science, Professor, Head of the Department of tissue and pathomorphological research methods

vasily-vlasyuk@yandex.ruНИИ детских инфекций, Санкт-ПетербургРоссияScientific Research Institute of Childhood Infections, St. PetersburgRussian Federation201307122013126Вопросы современной педиатрии4852Copyright © Власюк В.В., 20132013Власюк В.В.Vlasyuk V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/255

Описывается несоответствие принятой в настоящее время классификации внутрижелудочковых кровоизлияний в мозг патоморфологическим данным. Обосновывается противоречивость включения в классификацию субэпендимального (1-я стадия) и внутримозгового (4-я стадия) кровоизлияния. Предлагается классификация внутрижелудочковых кровоизлияний в мозг с выделением их источников, фаз и стадий. Наиболее частым источником внутрижелудочковых кровоизлияний является субэпендимальное кровоизлияние (82,2%). Выделено 2 фазы кровоизлияний: фаза кровотечения и фаза резорбции. Стадии внутрижелудочковых кровоизлияний, отражающие перемещение крови после начала кровоизлияния: 1 — заполнение кровью до 1/2 объема боковых желудочков без их расширения; 2 — заполнение кровью боковых желудочков более 1/2 объема с их расширением; 3 — заполнение кровью IV желудочка, большой цистерны мозга и ее перемещение в субарахноидальное пространство мозжечка, варолиева моста, продолговатого и спинного мозга.

Inconsistency of the current classification of cerebral intraventricular hemorrhages is discussed in the article. The author explains divergence of including of the subependymal (1st stage) and intracerebral (4th stage) hemorrhages into this classification. A new classification of cerebral intraventricular hemorrhages including their origin, phases and stages is offered. The most common origin of intraventricular hemorrhages is subependymal hemorrhage (82,2%). Two phases of hemorrhage were distinguished: bleeding phase and resorption phase. Stages of intraventricular hemorrhages reflecting the blood movement after the onset of bleeding are the following: 1 — infill of the up to ½ of the lateral ventricles without their enlargement; 2 — infill of more than ½ of the lateral ventricles with their enlargement; 3 — infill of the IV ventricle, of the cerebellomedullary cistern and its dislocation into the subarachnoid space of the cerebellum, pons varolii, medulla oblongata and spinal cord.

внутрижелудочковое кровоизлияние в мозгклассификациясубэпендимальное кровоизлияниекровоизлияние в герминативный матриксстадииосложненияcerebral intraventricular hemorrhageclassificationsubependymal hemorrhagegerminal matrix hemorrhagestagescomplicationsReferencesPapile L. A., Burstein J., Burstein R., Koffler H. Incidence and evolucion of subependimal and intraventricular hemorrhage: A study of infants with birth weights less than 1500 gm. Pediatrics. 1978; 92 (4): 529–534.Papile L. A., Burstein J., Burstein R., Koffler H. Incidence and evolucion of subependimal and intraventricular hemorrhage: A study of infants with birth weights less than 1500 gm. Pediatrics. 1978; 92 (4): 529–534.De Crespigny L., Mackay R., Murton L. J., Roy R., Robinson P. Timing of neonatal cerebroventricular hemorrhage with ultrasound. Arch. Dis. Childhood. 1982; 57: 231–233.De Crespigny L., Mackay R., Murton L. J., Roy R., Robinson P. Timing of neonatal cerebroventricular hemorrhage with ultrasound. Arch. Dis. Childhood. 1982; 57: 231–233.Iova А. S., Garmashov Yu. A., Andruschenko N. V., Pautnitskaya T. S. Ultrasonografiya v pediatrii (novye vozmozhnosti i perspektivy) [Ultrasonography in pediatrics (New Opportunities and Prospects)]. St. Petersburg, 1997. 160 p.Iova А. S., Garmashov Yu. A., Andruschenko N. V., Pautnitskaya T. S. Ultrasonografiya v pediatrii (novye vozmozhnosti i perspektivy) [Ultrasonography in pediatrics (New Opportunities and Prospects)]. St. Petersburg, 1997. 160 p.Volpe J. J. Neurology of the newborn. 5th ed. Philadelphia: Elsevier Health Sciences. 2008. 1094 p. 5. Aicardi G. Zabolevaniya nervnoy sistemy u detey: v 2 t. T. 1 [Diseases of the nervous system in children: In 2 volumes. Volume 1. Translation of 3rd English edition]. Moscow, BINOM Publ., 2013. 1036 p.Volpe J. J. Neurology of the newborn. 5th ed. Philadelphia: Elsevier Health Sciences. 2008. 1094 p. 5. Aicardi G. Zabolevaniya nervnoy sistemy u detey: v 2 t. T. 1 [Diseases of the nervous system in children: In 2 volumes. Volume 1. Translation of 3rd English edition]. Moscow, BINOM Publ., 2013. 1036 p.Shankaran S., Slovis T. L., Bedard M. P., Poland R. L. Sonographic classification of intracranial hemorrhage. A prognostic indicator of mortality, morbidity, and short-term neurologic outcome. J. Pediatr. 1982; 100 (3): 469–475.Shankaran S., Slovis T. L., Bedard M. P., Poland R. L. Sonographic classification of intracranial hemorrhage. A prognostic indicator of mortality, morbidity, and short-term neurologic outcome. J. Pediatr. 1982; 100 (3): 469–475.Levene M. J., Levene M. J., Grespighy L. Classification of IVH. Lancet. 1983. С. 643.Levene M. J., Levene M. J., Grespighy L. Classification of IVH. Lancet. 1983. С. 643.Voevodin S. M. Ekhograficheskaya diagnostika vnutricherepnykh krovoizliyaniy u plodov i novorozhdennykh. [Echographic diagnosis of intracranial hemorrhage in fetuses and newborns] In the book: Perinatalnaya nevrologiya. Izdaniye 2. [Perinatal Neurology. Ed. 2] Edited by Yu. I. Barashnev. Moscow, Triada-X Publ., 2011. P. 286–289.Voevodin S. M. Ekhograficheskaya diagnostika vnutricherepnykh krovoizliyaniy u plodov i novorozhdennykh. [Echographic diagnosis of intracranial hemorrhage in fetuses and newborns] In the book: Perinatalnaya nevrologiya. Izdaniye 2. [Perinatal Neurology. Ed. 2] Edited by Yu. I. Barashnev. Moscow, Triada-X Publ., 2011. P. 286–289.Mikhalyov E. V., Ermolenko S. P., Filippov G. P., Zhelev V. A., Elizarova M. G., Kharina O. P. Vnutrizheludochkovye krovoizliyaniya u nedonoshennykh novorozhdennykh (etiologiya, patogenez, diagnostika, lecheniye). Uchebnoye Posobiye [Intraventricular hemorrhage in preterm infants (etiology, pathogenesis, diagnosis and treatment). Teaching aid]. Tomsk, 2008.Mikhalyov E. V., Ermolenko S. P., Filippov G. P., Zhelev V. A., Elizarova M. G., Kharina O. P. Vnutrizheludochkovye krovoizliyaniya u nedonoshennykh novorozhdennykh (etiologiya, patogenez, diagnostika, lecheniye). Uchebnoye Posobiye [Intraventricular hemorrhage in preterm infants (etiology, pathogenesis, diagnosis and treatment). Teaching aid]. Tomsk, 2008.Antonov A. G., Burkova A. S., Baybarina E. N. Peri- i intraven trikulyarnye krovoizliyaniya u novorozhdennykh: profilaktika ikh vozniknov eniya i progressirovaniya [Peri-and intraventricular hemorrhage in the newborn: Prevention of their onset and progression]. Pediatriya — Pediatrics. 1996; 5: 39–42.Antonov A. G., Burkova A. S., Baybarina E. N. Peri- i intraven trikulyarnye krovoizliyaniya u novorozhdennykh: profilaktika ikh vozniknov eniya i progressirovaniya [Peri-and intraventricular hemorrhage in the newborn: Prevention of their onset and progression]. Pediatriya — Pediatrics. 1996; 5: 39–42.Vatolin K. V. Ultrazvukovaya diagnostika zabolevaniy golovnogo mozga u detey [Ultrasound diagnosis of brain diseases in children]. Moscow, 1995. 118 p.Vatolin K. V. Ultrazvukovaya diagnostika zabolevaniy golovnogo mozga u detey [Ultrasound diagnosis of brain diseases in children]. Moscow, 1995. 118 p.Rorke-Adams L., Larroche J-C., de Vries L. Fetal and neonatal brain damage. In: Potter's Pathology of the Fetus, Infant and Child. 2nd ed. Philadelphia. 2007. P. 2027–2058.Rorke-Adams L., Larroche J-C., de Vries L. Fetal and neonatal brain damage. In: Potter's Pathology of the Fetus, Infant and Child. 2nd ed. Philadelphia. 2007. P. 2027–2058.Khazanov A. I. Klinicheskaya neonatologiya [Clinical neonatology]. St. Petersburg, Gippokrat Publ., 2009. 456 p.Khazanov A. I. Klinicheskaya neonatologiya [Clinical neonatology]. St. Petersburg, Gippokrat Publ., 2009. 456 p.Vlasyuk V. V. Rodovaya travma i perinatalnye narusheniya mozgovogo krovoobrashcheniya [Birth trauma and perinatal cerebral circulation]. St. Petersburg, Nestor Istoriya Publ., 2009. 252 p.Vlasyuk V. V. Rodovaya travma i perinatalnye narusheniya mozgovogo krovoobrashcheniya [Birth trauma and perinatal cerebral circulation]. St. Petersburg, Nestor Istoriya Publ., 2009. 252 p.Vlasyuk V. V. Kliniko-morfologicheskiye klassifikatsii porazheniy tsentralnoy nervnoy sistemy perinatalnogo perioda [Clinical and morphological classification of lesions of the central nervous system during the perinatal period]. Arkhiv patologiy — Archives of Pathology. 2010; 6: 16–19.Vlasyuk V. V. Kliniko-morfologicheskiye klassifikatsii porazheniy tsentralnoy nervnoy sistemy perinatalnogo perioda [Clinical and morphological classification of lesions of the central nervous system during the perinatal period]. Arkhiv patologiy — Archives of Pathology. 2010; 6: 16–19.Palchik A. B., Fyodorova L. A., Ponyatishin A. E. Nevrologiya nedonoshennykh detey [Neurology in preterm infants]. Moscow, MEDpress-inform Publ., 2010. 342 p.Palchik A. B., Fyodorova L. A., Ponyatishin A. E. Nevrologiya nedonoshennykh detey [Neurology in preterm infants]. Moscow, MEDpress-inform Publ., 2010. 342 p.Zubareva E. A. Kompleksnaya ultrazvukovaya otsenka perinatalnykh tserebrovaskulyarnykh narusheniy u detey pervogo goda zhizni [Comprehensive ultrasound evaluation of prenatal cerebrovascular disorders in infants]. Avtoreferat-dissertatsiya doktora meditsinskikh nauk [Autoabstract-thesis of Doctor of Medical Science]. Moscow, 2006. 46 p.Zubareva E. A. Kompleksnaya ultrazvukovaya otsenka perinatalnykh tserebrovaskulyarnykh narusheniy u detey pervogo goda zhizni [Comprehensive ultrasound evaluation of prenatal cerebrovascular disorders in infants]. Avtoreferat-dissertatsiya doktora meditsinskikh nauk [Autoabstract-thesis of Doctor of Medical Science]. Moscow, 2006. 46 p.

The authors declare that there are no conflicts of interest present.