Periventricular leulomalacia: ultrasound diagnosis and fllow-up

Periventricular leulomalacia: ultrasound diagnosis and fllow-up

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ABSTRACT Periventricular leukomalacia (PVL) is defined as ischemic infarction of the white matter located around the lateral ventricles of the premature infant's brain. PVL is caused by the hypoperfusion of end arteries that supply the white matter in the watershed areas between the major cerebral arteries. From January 1984 to October 1988, 506 newborns with a gestational age ≤ 34 weeks, admitted to NICU of Padua were routinely scanned. Thirthy newborns (5.9%) were diagnosed to have cavitary PVL. Concomitant PVH-IVH occurred in 14 infants (46.77%). Twenty-seven babies survived and 3 died. Twenty-four (80%) of the 30 newborns showed areas of increased echogenicity in the periventricular regions prior to the development of cystic changes. The mean age for the appearance of hyperachogenicity was 3 days (range 1-26). The mean age for the appearance of cysts was 23 days (range 8-521. PVL was divided into localized and extensive lesions. Twenty newborns had localized PVL, 13 unilateral (2 frontal, 4 parietal 7 occipital) and 7 bilateral (2 frontal, 5 occipital). Ten newborns had extensive and bilateral PVL (8 frontal, 9 parietal, 10 occipital). Discharged babies were followed-up by repeated ultrasound scans. In 14 infants followed beyond 6 months postnatal age the cysts disappeared, in 6 they were still visible. Fifteen infants had associated mild-moderate ventricular dilation, 5 had cerebral atrophy. The 12 months (corrected age) neurodevelopmental outcome of 17 survivors is reported. Eleven babies showed cerebral palsy, 4 of them had a severe mental delay, 3 a moderate mental delay and 4 were normal. One baby showed a mild showed delay and a normal mental development. Five babies had a normal motor development, 1 of them had a moderate mental delay and 4 were normal. In conclusion, PVL is related with a poor neurodevelopmental outcome, particularly when lesions are extensive, localized and bilateral, above all when the occipital lobe is envolved. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Pediatrics, University of Padua, Italy O S Saia, A Vozzi, A Flore, P Srifiith, I Angonese, C Zerzi & F Cantaratti Authors * O S Saia View author publications You can also search for this author inPubMed Google Scholar * A Vozzi View author publications You can also search for this author inPubMed Google Scholar * A Flore View author publications You can also search for this author inPubMed Google Scholar * P Srifiith View author publications You can also search for this author inPubMed Google Scholar * I Angonese View author publications You can also search for this author inPubMed Google Scholar * C Zerzi View author publications You can also search for this author inPubMed Google Scholar * F Cantaratti View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Saia, O., Vozzi, A., Flore, A. _et al._ PERIVENTRICULAR LEULOMALACIA: ULTRASOUND DIAGNOSIS AND FLLOW-UP. _Pediatr Res_ 26, 506 (1989). https://doi.org/10.1203/00006450-198911000-00040 Download citation * Issue Date: 01 November 1989 * DOI: https://doi.org/10.1203/00006450-198911000-00040 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

ABSTRACT Periventricular leukomalacia (PVL) is defined as ischemic infarction of the white matter located around the lateral ventricles of the premature infant's brain. PVL is caused by


the hypoperfusion of end arteries that supply the white matter in the watershed areas between the major cerebral arteries. From January 1984 to October 1988, 506 newborns with a gestational


age ≤ 34 weeks, admitted to NICU of Padua were routinely scanned. Thirthy newborns (5.9%) were diagnosed to have cavitary PVL. Concomitant PVH-IVH occurred in 14 infants (46.77%).


Twenty-seven babies survived and 3 died. Twenty-four (80%) of the 30 newborns showed areas of increased echogenicity in the periventricular regions prior to the development of cystic


changes. The mean age for the appearance of hyperachogenicity was 3 days (range 1-26). The mean age for the appearance of cysts was 23 days (range 8-521. PVL was divided into localized and


extensive lesions. Twenty newborns had localized PVL, 13 unilateral (2 frontal, 4 parietal 7 occipital) and 7 bilateral (2 frontal, 5 occipital). Ten newborns had extensive and bilateral PVL


(8 frontal, 9 parietal, 10 occipital). Discharged babies were followed-up by repeated ultrasound scans. In 14 infants followed beyond 6 months postnatal age the cysts disappeared, in 6 they


were still visible. Fifteen infants had associated mild-moderate ventricular dilation, 5 had cerebral atrophy. The 12 months (corrected age) neurodevelopmental outcome of 17 survivors is


reported. Eleven babies showed cerebral palsy, 4 of them had a severe mental delay, 3 a moderate mental delay and 4 were normal. One baby showed a mild showed delay and a normal mental


development. Five babies had a normal motor development, 1 of them had a moderate mental delay and 4 were normal. In conclusion, PVL is related with a poor neurodevelopmental outcome,


particularly when lesions are extensive, localized and bilateral, above all when the occipital lobe is envolved. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of


Pediatrics, University of Padua, Italy O S Saia, A Vozzi, A Flore, P Srifiith, I Angonese, C Zerzi & F Cantaratti Authors * O S Saia View author publications You can also search for this


author inPubMed Google Scholar * A Vozzi View author publications You can also search for this author inPubMed Google Scholar * A Flore View author publications You can also search for this


author inPubMed Google Scholar * P Srifiith View author publications You can also search for this author inPubMed Google Scholar * I Angonese View author publications You can also search


for this author inPubMed Google Scholar * C Zerzi View author publications You can also search for this author inPubMed Google Scholar * F Cantaratti View author publications You can also


search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Saia, O., Vozzi, A., Flore, A. _et al._ PERIVENTRICULAR


LEULOMALACIA: ULTRASOUND DIAGNOSIS AND FLLOW-UP. _Pediatr Res_ 26, 506 (1989). https://doi.org/10.1203/00006450-198911000-00040 Download citation * Issue Date: 01 November 1989 * DOI:


https://doi.org/10.1203/00006450-198911000-00040 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is


not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative