RADIOLOGY: HEAD: Case# 33651: GRADE I SUBEPENDYMAL HEMORRHAGE. 5 day old premature infant presented for routine screening. Homogeneous, highly echogenic material is seen in the region of the caudothalamic groove, and appears separate from the normal choroid. The ventricles are otherwise without evidence of clot or dilatation. Germinal matrix hemorrhage may occur in the subependymal, intraventricular, or intraparenchymal regions. The germinal matrix is a network of blood vessels and primitive neural tissue that lines the ventricles during fetal life. By term only a small amount of Germinal Matrix is present in the caudothalamic groove. This network is highly sensitive to metabolic and pressure changes and easily undergoes hemorrhage. The typical classification scheme is as follows: Grade I- subependymal hemorrhage Grade 2- Intraventricular without hydrocephalus, Grade 3- Intraventricular with hydrocephalus, and Grade 4- Intraparenchymal with or without hydrocephalus.