USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

Which complication is most commonly associated with neonatal intravascular hemorrhage?

1. Hypotension

2. Hyperactivity

3. Seizures

4. Long-term neurodevelopmental impairment

The correct answer is: Long-term neurodevelopmental impairment

Neonatal intraventricular hemorrhage (IVH) is a significant condition often observed in premature infants, particularly those weighing less than 1500 grams. One of the most devastating complications of IVH is long-term neurodevelopmental impairment. This type of hemorrhage can lead to a range of neurological issues, including cognitive deficits, motor dysfunction, and behavioral problems as the child grows. The developmental impairment results from injury to the brain that occurs during the hemorrhage, as well as potential disruptions in later brain development. The vulnerability of the neonatal brain, along with factors like hypoxia and fluctuations in blood pressure, can contribute to these long-lasting neurodevelopmental challenges. In contrast, while hypotension, hyperactivity, and seizures may be observed in neonates with various complications, they do not capture the enduring impact of neonatal IVH in the same way. Long-term neurodevelopmental impairment represents a significant concern as it encompasses a wide spectrum of potential cognitive and physical disabilities that can emerge as a result of early brain injury. Thus, the association of neonatal intraventricular hemorrhage with long-term neurodevelopmental impairment is particularly salient in understanding the outcomes of this condition.