Supportive care includes the correction of underlying medical disturbances that might be related to the development of periventricular hemorrhageintraventricular hemorrhage (PVH-IVH) as well as cardiovascular, respiratory, and neurological support. Correction of anemia, acidosis, and hypotension, as well as ventilatory support, might be required in those neonates who present with acute deterioration. Seriallumbar puncture, although once used to prevent progressive hydrocephalus, is not indicated.Surgical CareSurgical support for PVH-IVH is limited to intervention for posthemorrhagic hydrocephalus. Because most patients with hydrocephalus following PVH-IVH demonstrate spontaneous resolution within weeks of onset, surgical intervention is usually unnecessary. Seriallumbar punctureshave been used to manage early hydrocephalus. However, because spontaneous resolution of hydrocephalus is usually observed, the use of this intervention has been questioned. A multicenter evaluation of serial lumbar punctures demonstrated no benefit when the individual with PVH-IVH is aged 30 months. The role of serial lumbar punctures in the management of late or rapidly progressive hydrocephalus remains controversial. Acetazolamide may be used to diminish CSF production and limit late or rapidly progressive hydrocephalus. Its use in the treatment of early ventricular dilatation is probably limited. Ventriculostomy placement may be required for the management of significant hydrocephalus while awaiting definitive surgical drainage. Ventriculoperitoneal and ventriculosubgaleal shunting remain the definitive treatments for posthemorrhagic hydrocephalus requiring surgical intervention.Consultations Consult neurosurgery in the event of rapidly progressive ventricular enlargement or prolonged (>4 wk) slowly progressive ventricular enlargement. Neurology consultation might be of value in the event of intractable seizures in an individual with PVH-IVH. A developmental interventionist might be of help with a patient with high-grade hemorrhages.