Histopathology of CHI demonstrates a multifocal hemorrhagic process and is associated with cortical hypoxic-ischemic injury or atrophy. a Multiple hemorrhages arising from different folia with multifocal extension into the leptomeninges in an infant of 25 weeks gestation who survived about 3 weeks. There are multiple areas of focal cortical loss, one of which is indicated by an arrow. Hemorrhages appear to be centered in the folia and show a mixture of acute and subacute changes suggesting that CHI may be due to repeated hemorrhagic episodes. b Left panel shows a higher magnification of the area marked by * in a demonstrating acute hemorrhage with scattered hemosiderin-laden macrophages (arrows). Right panel shows the area marked by ** in a at higher magnification demonstrating many hemosiderin-laden macrophages in an organizing cavity. c Chronic CHI with cavitation, hemosiderin and cholesterol clefts in the brain depicted in Figure 1e. d Atrophic cerebellar cortex uninvolved by hemorrhage from the sagittal section depicted in Figure 2c. e A larger hemorrhage extending into the leptomeninges with other smaller hemorrhages nearby in the white matter suggesting that the larger hemorrhages may represent a coalescence of multiple smaller hemorrhages (gross pathology is depicted in Figure 2a,b). f Three acute hemorrhages in the deep cortex and superficial white matter in a 29 weeks gestation infant who survived 3 weeks. The focal loss of gliotic cerebellar cortex (arrow) is consistent with a hypoxic-ischemic episode. All photomicrographs are taken from hematoxylin and eosin stained sections. a bar is 500 μm. b bar is 50 μm. c bar is 1 mm. d- f bar is 500 μm.Cerebellar hemorrhagic injury in premature infants occurs during a vulnerable developmental period and is associated with wider neuropathology. Haines KM, Wang W, Pierson CR - Acta neuropathologica communications (2013). Not Altered. CC.