confirmed by the presence of blood inside the ventricles on CT. Infants In term and preterm infants with IVH, the amount of bleeding varies. IVH is often described in four grades: Grade I - bleeding occurs just in the germinal matrix Grade II - bleeding also occurs inside the ventricles, but they are not enlarged Grade III - ventricles are enlarged by the accumulated blood Grade IV - bleeding extends into the brain tissue around the ventricles Grades I and II are most common, and often there are no further complications. Grades III and IV are the most serious and may result in long-term brain injury to the infant. After a grade III or IV IVH, blood clots may form which can block the flow of cerebrospinal fluid, leading to increased fluid in the brain (hydrocephalus). Prevention Head positioning in very preterm infants has been suggested as an approach to prevent germinal matrix haemorrhage; however, further research is required to determine the effectiveness at reducing mortality and the most appropriate positioning technique. Approaches include bed tilting, supine mid-line head positioning, supine head rotation 90 degrees, prone mid-line head positioning, head tiling. Treatment Treatment focuses on monitoring and should be accomplished with inpatient floor service for individuals responsive to commands or neurological ICU observation for those with impaired levels of consciousness. Extra attention should be placed on intracranial pressure (ICP) monitoring via an intraventricular catheter and medications to maintain ICP, blood pressure, and coagulation. In more severe cases an external ventricular drain may be required to maintain ICP and evacuate the hemorrhage, and in extreme cases an open craniotomy may be required. In cases of unilateral IVH with small intraparenchymal hemorrhage the combined method of stereotaxy and open craniotomy has produced promising results. Infants There have been various therapies employed into preventing the high rates of morbidity and mortality, including diuretic therapy, repeated lumbar puncture, streptokinase therapy and a combination novel intervention called DRIFT (drainage, irrigation and fibrinolytic therapy). More research is required, in the form of high quality randomized controlled trials, to determine the safety, dosing, and effectiveness of prophylactic heparin and antithrombin treatment for preterm neonates. Prognosis In infants, germinal matrix haemorrhage is associated with cerebral palsy, problems with cognition, and hydrocephalus. With improved technological advances in science and medicine, survival for preterm infants with this type of neurological disorder has improved and less preterm infants with germinal matrix