Brain and eye conditions

This section describes some of the most common brain and eye conditions babies have in the NICU:

• hydrocephalus
• Hypoxic ischemic encephalopathy
• Intraventricular hemorrhage
• Retinopathy of prematurity

hydrocephalus (hye-droh-SEF-uh-lus)
What it is: A buildup of fluid inside a baby’s head that causes brain swelling. It means “water on the brain.” This can happen during pregnancy or after a baby is born. Sometimes hydrocephalus can be caused by another condition like spina bifida (a birth defect that affects the lower back and, sometimes, the spinal cord).

Treatment: Treatment includes surgery to reduce the buildup of fluid on the brain. A thin plastic tube (called a shunt) is placed in the baby’s brain to move the extra fluid to another location in the body. If a baby has hydrocephalus because of a blockage, surgery is done to fix the problem.


hypoxic ischemic encephalopathy (hye-POKS-ik is-KEE-mik en-sef-uh-LOP-uh-thee)
What it is: Also called HIE. This condition happens when a baby’s brain or body doesn’t get enough oxygen and blood. It can happen during pregnancy, labor, birth or after birth.

Treatment: For serious cases, a cooling blanket or cap can help to bring the baby’s temperature down. This treatment helps reduce or prevent problems that can happen when there isn’t enough oxygen getting to the baby’s brain.

intraventricular hemorrhage (in-trah-ven-TRIK-yoo-lar HEM-ur-ij)
What it is: Also called IVH. A condition in which there is bleeding in a baby’s brain. This condition is most common in premature babies (born before 37 weeks of pregnancy) who weigh less than 3 1/3 pounds. Most of the time, the bleeding happens in the first 4 days after the baby is born. In serious cases, the bleeding causes fluids to build up in the baby’s brain.

Treatment: Providers use ultrasound (a test that uses sound waves to take pictures of the inside of the body) to check for bleeding in the brain. If bleeding is found, it is graded from 1 to 4, with 4 being the most serious. Most brain bleeds are mild (called grade 1 and grade 2), get better without treatment and usually do not cause lasting problems. Treatment for more serious bleeding problems, may include putting a tube (called a shunt) in the baby’s brain to relieve pressure by draining built-up fluid.

retinopathy of prematurity (ret-in-OPuh-thee of pree-muh-CHOOR-uh-tee)
What it is: Also called ROP. When blood vessels in a baby’s eyes don’t develop the right way. ROP happens most often in premature babies born before 30 weeks of pregnancy. It can cause bleeding and scarring that harm the eye. Sometimes ROP causes damage to the eye’s retina (the lining at the back of the eye that sends images of things someone sees to their brain) and affects vision. Vision loss may be mild to severe.

Treatment: An ophthalmologist (eye doctor) checks a baby’s eyes for signs of ROP. Most mild cases get better without treatment, and there is little or no vision loss. In more serious cases, the doctor may use a laser or other treatments to help fix bleeding and scars. These treatments help protect the baby’s eyes.