The IVH medical abbreviation stands for intraventricular hemorrhage, which is bleeding into the ventricles, the fluid-filled spaces deep inside the brain. It is best known in newborn intensive care, where it mainly affects babies born early, but adults can have it too, usually alongside another kind of brain bleed.
Parents often first see the letters on a head ultrasound result, and nursing students meet them in neonatal and neurocritical care rotations. Below you will find what the word parts mean, how doctors grade an IVH, the tests and procedures that tend to follow, and an older meaning that occasionally appears in records. Related procedures sit in the surgery and procedures section.
At a glance
Stands for
Intraventricular hemorrhageWord parts
Intra (within) + ventricular (the brain's ventricles) + hemorrhage (bleeding)Used in
Neonatal intensive care, neurology, neurosurgery, neurocritical careGraded as
Grade I to IV in premature babiesWhere you see it
Head ultrasound, CT and MRI reports, NICU progress notesOlder meaning
Intravenous hyperalimentation, an old name for IV nutritionDo not confuse with
What the IVH medical abbreviation describes
The brain has four connected chambers called ventricles. They make and hold cerebrospinal fluid, the clear liquid that cushions the brain and spinal cord. In an IVH, blood leaks into these chambers. The bleed may start in tissue next to a ventricle and break through, or it may begin right at the ventricle wall.
In a premature baby, the usual source is the germinal matrix, a fragile patch of tiny blood vessels near the ventricles that normally fades away as the baby matures. In adults, IVH more often comes from a bleed elsewhere in the brain spreading into the ventricles, from a ruptured aneurysm, or from a head injury. Context tells you which group the note is about.
How an IVH is graded in premature babies
For preterm infants, teams use a four-step grading scale based on how far the blood spreads on imaging. Higher grades are more serious, though each baby's outlook depends on many factors that only their care team can weigh.
| Grade | What imaging shows |
|---|---|
| I | Bleeding limited to the germinal matrix |
| II | Blood inside the ventricle, without enlarging it |
| III | Blood inside the ventricle, which has become enlarged |
| IV | Bleeding that also involves the brain tissue beside the ventricle |
Grades I and II are often called low grade. Grades III and IV are high grade. Some hospitals now describe grade IV as a periventricular hemorrhagic infarction, but the older label is still common in reports.
Reading IVH on a head ultrasound report
Because a newborn's skull has a soft spot called the fontanelle, doctors can look at the brain with ultrasound at the bedside, with no radiation. Many NICUs screen babies born very early with routine head scans in the first days of life, since most of these bleeds happen soon after birth.
NICU note: "HUS: bilateral grade I IVH, stable from prior. Repeat in 1 week." HUS is head ultrasound, bilateral means both sides, and stable from prior means no change since the last scan. It is an example of the wording, not a description of any real child.
In adults, the bleed is usually found on a CT of the head, and an MRI can follow when finer detail is needed.
Procedures and monitoring that may follow
Blood in the ventricles can block the normal flow of spinal fluid. When fluid builds up, the ventricles widen, a problem called hydrocephalus. This is why care plans after an IVH often include repeat imaging and head size checks in babies.
If pressure rises, neurosurgeons may place an EVD, a temporary drain that lets fluid out and allows ICP, the pressure inside the skull, to be measured. In infants, a reservoir under the scalp or, later, a permanent shunt may be used. These choices depend on the size of the bleed and how the child or adult is doing.
Other brain bleed abbreviations compared
Each type of brain bleed takes its name from the spot where blood collects. The letters look alike, and a table makes the differences easier to see.
| Abbreviation | Full term | Location of blood |
|---|---|---|
| IVH | Intraventricular hemorrhage | Inside the ventricles |
| ICH | Intracerebral hemorrhage | Within brain tissue |
| SAH | Subarachnoid hemorrhage | In the space around the brain surface |
| SDH | Subdural hematoma | Under the tough outer covering of the brain |
A single scan can show more than one of these, so a report may list ICH with IVH extension, for example.
An older meaning and charting tips for students
In older records and some nutrition texts, IVH meant intravenous hyperalimentation, an early name for feeding through a vein. Today that is called parenteral nutrition, written TPN when it supplies all nutrition. If IVH appears next to words like dextrose, lipids or central line, the older meaning may be intended.
Students charting in a NICU should copy the grade and side exactly as the imaging report states, and avoid adding a grade that was not given.
Every baby and adult is different, so questions about a particular scan result are best taken to the team looking after that person.
Frequently asked questions
What does IVH mean in a premature baby?
It means bleeding into the fluid spaces of the brain, which happens more often in babies born early because the blood vessels near the ventricles are fragile. The care team grades it from I to IV based on imaging.
Is a grade I IVH serious?
Grade I is the mildest level on the scale, with blood limited to a small area. Many low-grade bleeds are watched with repeat scans. The baby's own doctors are the right people to explain what it means in that child's case.
How is IVH found?
In newborns, a bedside head ultrasound through the soft spot is the usual test. In older children and adults, a CT scan of the head is typically used first.
What is the difference between IVH and ICH?
IVH means the blood is inside the ventricles. ICH means the bleed is within brain tissue itself. An ICH can spread into the ventricles, and reports then mention both.
Can IVH mean anything else?
In older records, IVH sometimes stood for intravenous hyperalimentation, an early term for nutrition given by vein. Modern charts use parenteral nutrition or TPN for that.