What should we do now?
I think we should stop using the Papile classification.
We should clarify that an intraventricular hemorrhage with acute hemorrhagic dilatation of the ventricle(s) is not the same pathophysiology as a hemorrhage followed by dilatation. (stage 2 followed by PHVD compared to a stage 3)
We should differentiate between an acute intra-parenchymal echodensity (which may be hemorrhagic or edematous) and PVHI, associated with intraventricular blood on the ispilateral side.
We should analyze and record the brain regions affected by the PVHI or IPE.
We should follow, and report the outcomes, of several hundreds of individuals, in order to have reliable information.
In other words, we should abandon the Papile classification, we should use descriptive terms to interpret head ultrasounds, we should use published percentiles to determine if a ventricle is dilated or not, we should record the brain regions affected on ultrasound, unilateral and bilateral, and we should work at correlating these findings with long-term outcomes.