Harrison's Brain

Most of you know Harrison suffered from a Level 3 Intraventricular hemorrhage or brain bleed. IVH is bleeding inside or around the ventricles. Dr. Thomas sat us down a few days after delivery to tell us what had been found during an US (ultra sound). He said it really looked like a level 2 bleed, but he had to go with the diagnosis given by the radiologist. A lot of preemies experience this and it can cause long lasting effects. It is thought that it could happen when there is too little oxygen going to the brain with a difficult or traumatic birth, or from complications after delivery. The smaller and more premature the baby, the more likely IVH will occur. Nearly all IVH occurs within the first three days of life.

There's 4 different levels. Grade I is a bleed in the germinal matrix (an area of the brain only newborns have). Grade II is a bleed in the gerinal matrix with bleeding into the ventricles. Grade III is a bleed into the ventricles that causes swelling of the ventricles. Grade IV is a bleed that causes cysts in the brain.Grades I and II are not correlated with any brain damage - unclear whether they might routinely occur in full term infants but go undetected. Grades III and IV are correlated with greater incidence of brain damage.

Harrison had NUMEROUS head ultra sounds in the NICU to make sure the bleed was resolving and it was. He had an MRI January 26, 2011 at ACH. Findings: Mild to moderate prominence of the lateral ventricles and extra fluid spaces. There was a small area of encephalomalacia in the right caudate head.The encephalomalacia is considered a brain injury, however a baby's brain can heal and compensate for injuries that we as adults would not be able to recover from without some lasting effects. Evidence of old blood product deposition was noted in the lateral ventricles bilaterally particularly in the occipital horns. Evidence of previous subarachnoid hemorrhage is noted around the brainstem. Also, NO ACUTE ABNORMALITIES WERE SEEN! Dr. Kaiser, Associate Professor of Neonatology, who does a TON of brain research at ACH, called and transcribed all this for me. I was a little confused!! Basically, the bleed was in the resolution process and the ventricles were still dialated. We talked about the damage that was done and how other parts of the brain can take over. He said expect delays and possible disabilites. He was very positive and told us the next steps, which included immediate therapy. I immediately contacted Easter Seals the next day to get the ball rolling.

Harrison had another head US at ACH last Friday at the High Risk Newborn Clinic. Findings: Moderate enlargement of the lateral ventricles and moderate prominenc of fluid, which was seen on the MRI in January. No echogenic debris was seen within the extra-axial CSF spaces. No focal cystic or echogenic brain parenchymal lesions were seen. The nurse called and said it's doing exactly what it should and is still in the resolution process.

 I decided to call Dr. Kaiser bc my head was spinning! I left a message and figured his nurse would call me back. Boy was I wrong, he called me back 20 minutes later. Very impressive! He pulled up Harrison's ultra sounds from the NICU, MRI, and latest  head US done last Friday so we could discuss. He  was very surprised Harrison didn't develop hydrocephalus, considering he had a level 3 bleed. He said Harrison had had a better outcome than most. There's also NO MORE evidence of old blood, it had all been broken down. Fluid was still present and ventricles slightly enlarged. Overall, no change from January til now, which is good and part of the resolution process. Dr. Kaiser was very positive and hopeful that Harrison will catch up and lead a normal life.  IF there is any impact from the bleed we won't know until a delay or problem appears - that is a BIG IF! There is a great chance Harrison will be fine! We have decided to take it as it comes and of course hope for the best and expect amazing things from our son (we dont want to limit him by having low expectations). We're ready to take on anything! You just never can tell with a babies brain. They have so much time to "rewire" & adjust for damage... One day at a time!


Harrison will have a CT brain scan in July. His therapist says he's making progress, but it's slow.  All we can do is pray and provide every opportunity to help him learn and grow. I love this little boy SO much!! All his Dr.'s say he's made leaps and bounds for a 26 weeker!! I'm one proud momma! I'm sure I'll look back someday and think why did I stress out about milestones?? It's all on Harrison's terms.