{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:30:58Z","timestamp":1778221858435,"version":"3.51.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Intraventricular hemorrhage during the early stage is a major complication in very low birth weight infants. Elevation of venous pressure is one of the contributing factors. The internal cerebral vein receives most of the venous flow from the subependymal germinal matrix, the most common site of origin of intraventricular hemorrhage. Recently, it has been reported that pulsatile or partially interrupted internal cerebral vein waveforms might also be risk factors for intraventricular hemorrhage in extremely low birth weight infants. Here, we report two cases of partially reversed internal cerebral vein flow with intraventricular hemorrhage. There are no published reports documenting this unique flow pattern.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>Between 2013 and 2020, we had in our neonatal intensive care unit two cases of very low birth weight infants (27 and 25 weeks of gestational age) who showed a partially reversed internal cerebral vein waveform pattern, which was recognized as a new blood flow pattern. Their internal cerebral vein flow patterns were continuously flat early after birth. They showed an intraventricular hemorrhage on the unilateral side with partially interrupted internal cerebral vein flow at 31 and 41 hours after birth (27- and 25-week-old neonates, respectively). Consecutively, their internal cerebral vein flow changed to a partially reversed pattern with intraventricular hemorrhage on the contralateral side at 43 and 87 hours after birth (27- and 25-week-old neonates, respectively). Their flow patterns improved by day 7. These partially reversed patterns were equivalent to triphasic venous flow, and the reverse flow corresponded to A- and V-waves.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In the two cases, the internal cerebral vein flow patterns were normal and flat before intraventricular hemorrhage and changed to a severe flow pattern (partially interrupted or reversed flow) at the same time as the detection of intraventricular hemorrhage. After the development of intraventricular hemorrhage, they improved. These cases indicate that a partially reversed or interrupted internal cerebral vein flow pattern may be derived from central venous pressure elevation and related to intraventricular hemorrhage in very low birth weight infants, however, it is difficult to determine when this flow pattern occurs in relation to intraventricular hemorrhage.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12887-020-02414-0","type":"journal-article","created":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T04:30:38Z","timestamp":1605069038000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Reversal of blood flow in deep cerebral vein in preterm intraventricular hemorrhage: two case reports"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8228-2536","authenticated-orcid":false,"given":"Kenichi","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rieko","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Naramura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirou","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Iwai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Mitsubuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimitoshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"2414_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1203\/PDR.0b013e3181c1b176","volume":"67","author":"P Ballabh","year":"2010","unstructured":"Ballabh P. Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res. 2010;67:1\u20138.","journal-title":"Pediatr Res"},{"key":"2414_CR2","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/B978-0-323-42876-7.00024-7","volume-title":"Volpe\u2019s neurology of the newborn","author":"TE Inder","year":"2018","unstructured":"Inder TE, Perlman JM, Volpe JJ. Preterm intraventricular hemorrhage\/posthemorrhagic hydrocephalus. In: Volpe JJ, Inder TE, Darras BT, de Vries LS, du Plessis AJ, Neil JJ, Perlman JM, editors. Volpe\u2019s neurology of the newborn. 6th ed. Philadelphia: Elsevier; 2018. p. 637 \u2013 98.e21.","edition":"6"},{"key":"2414_CR3","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s00431-014-2396-1","volume":"174","author":"T Ikeda","year":"2015","unstructured":"Ikeda T, Amizuka T, Ito Y, Mikami R, Matsuo K, Kawamura N, et al. Changes in the perfusion waveform of the internal cerebral vein and intraventricular hemorrhage in the acute management of extremely low-birth-weight infants. Eur J Pediatr. 2015;174:331\u20138.","journal-title":"Eur J Pediatr"},{"key":"2414_CR4","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1148\/radiology.183.2.1561348","volume":"183","author":"GA Taylor","year":"1992","unstructured":"Taylor GA. Intracranial venous system in the newborn: evaluation of normal anatomy and flow characteristics with color doppler US. Radiology. 1992;183:449\u201352.","journal-title":"Radiology"},{"key":"2414_CR5","first-page":"219","volume":"18","author":"HS Ghazi-Birry","year":"1997","unstructured":"Ghazi-Birry HS, Brown WR, Moody DM, Challa VR, Block SM, Reboussin DM. Human germinal matrix: venous origin of hemorrhage and vascular characteristics. AJNR Am J Neuroradiol. 1997;18:219\u201329. .","journal-title":"AJNR Am J Neuroradiol."},{"key":"2414_CR6","first-page":"475","volume":"4","author":"Y Nakamura","year":"1991","unstructured":"Nakamura Y, Okudera T, Hashimoto T. Microvasculature in germinal matrix layer: its relationship to germinal matrix hemorrhage. Mod Pathol. 1991;4:475\u201380.","journal-title":"Mod Pathol."},{"key":"2414_CR7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1046\/j.1469-0705.1999.13010034.x","volume":"13","author":"H Laurichesse-Delmas","year":"1999","unstructured":"Laurichesse-Delmas H, Grimaud O, Moscoso G, Ville Y. Color Doppler study of the venous circulation in the fetal brain and hemodynamic study of the cerebral transverse sinus. Ultrasound Obstet Gynecol. 1999;13:34\u201342.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2414_CR8","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1148\/rg.297095715","volume":"29","author":"MH Scheinfeld","year":"2009","unstructured":"Scheinfeld MH, Bilali A, Koenigsberg M. Understanding the spectral Doppler waveform of the hepatic veins in health and disease. Radiographics. 2009;29:2081\u201398.","journal-title":"Radiographics"},{"key":"2414_CR9","volume-title":"Clinical Methods: The history, physical, and laboratory examinations","author":"MM Applefeld","year":"1990","unstructured":"Applefeld MM. The jugular venous pressure and pulse contour. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990. .","edition":"3"},{"key":"2414_CR10","doi-asserted-by":"publisher","first-page":"151","DOI":"10.2214\/ajr.164.1.7998529","volume":"164","author":"LM Dean","year":"1995","unstructured":"Dean LM, Taylor GA. The intracranial venous system in infants: normal and abnormal findings on duplex and color Doppler sonography. AJR Am J Roentgenol. 1995;164:151\u20136.","journal-title":"AJR Am J Roentgenol"},{"key":"2414_CR11","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1002\/pd.1062","volume":"24","author":"T Kiserud","year":"2004","unstructured":"Kiserud T, Acharya G. The fetal circulation. Prenat Diagn. 2004;24:1049\u201359.","journal-title":"Prenat Diagn"},{"key":"2414_CR12","first-page":"237","volume":"82","author":"D Oepkes","year":"1993","unstructured":"Oepkes D, Vandenbussche FP, Van Bel F, Kanhai HH. Fetal ductus venosus blood flow velocities before and after transfusion in red-cell alloimmunized pregnancies. Obstet Gynecol. 1993;82:237\u201341.","journal-title":"Obstet Gynecol"},{"key":"2414_CR13","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1111\/aogs.12893","volume":"95","author":"V Seravalli","year":"2016","unstructured":"Seravalli V, Miller JL, Block-Abraham D, Baschat AA. Ductus venosus Doppler in the assessment of fetal cardiovascular health: an updated practical approach. Acta Obstet Gynecol Scand. 2016;95:635\u201344.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2414_CR14","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/0046-8177(90)90256-5","volume":"21","author":"Y Nakamura","year":"1990","unstructured":"Nakamura Y, Okudera T, Fukuda S, Hashimoto T. Germinal matrix hemorrhage of venous origin in preterm neonates. Hum Pathol. 1990;21:1059\u201362.","journal-title":"Hum Pathol"},{"key":"2414_CR15","doi-asserted-by":"publisher","first-page":"e3907","DOI":"10.1097\/MD.0000000000003907","volume":"95","author":"H Zhang","year":"2016","unstructured":"Zhang H, Song S, Ouyang Z. Intraventricular hemorrhage caused by intracranial venous sinus thrombosis: Case report. Medicine. 2016;95:e3907.","journal-title":"Medicine"},{"key":"2414_CR16","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7569479","author":"LY Liu","year":"2019","unstructured":"Liu LY, Hong JL, Wu CJ. A preliminary study of neonatal cranial venous system by color Doppler. Biomed Res Int. 2019. doi:https:\/\/doi.org\/10.1155\/2019\/7569479.","journal-title":"Biomed Res Int"},{"key":"2414_CR17","first-page":"697","volume":"93","author":"RK Pooh","year":"1999","unstructured":"Pooh RK, Pooh KH, Nakagawa Y, Maeda K, Fukui R, Aono T. Transvaginal Doppler assessment of fetal intracranial venous flow. Obstet Gynecol. 1999;93:697\u2013701.","journal-title":"Obstet Gynecol"},{"key":"2414_CR18","doi-asserted-by":"publisher","first-page":"68","DOI":"10.3389\/fped.2020.00068","volume":"8","author":"MR Popescu","year":"2020","unstructured":"Popescu MR, Panaitescu AM, Pavel B, Zagrean L, Peltecu G, Zagrean AM. Getting an early start in understanding perinatal asphyxia impact on the cardiovascular system. Front Pediatr. 2020;8:68.","journal-title":"Front Pediatr"},{"key":"2414_CR19","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/S0021-9290(00)00041-5","volume":"33","author":"LR Hellevik","year":"2000","unstructured":"Hellevik LR, Stergiopulos N, Kiserud T, Rabben SI, Eik-Nes SH, Irgens F. A mathematical model of umbilical venous pulsation. J Biomech. 2000;33:1123\u201330.","journal-title":"J Biomech"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-020-02414-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12887-020-02414-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-020-02414-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T04:31:31Z","timestamp":1605069091000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-020-02414-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,11]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2414"],"URL":"https:\/\/doi.org\/10.1186\/s12887-020-02414-0","relation":{},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,11]]},"assertion":[{"value":"29 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All examinations and investigations in these cases were approved by the institutional review board of Kumamoto University (registration No. 2204). Written informed consent was obtained from the parents before inclusion into the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the parents of the two patients for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"517"}}