Read about periventricular leucomalacia PVL , which kills brain tissues. PVL can lead to motor disorders, such as cerebral palsy. Periventricular leucomalacia PVL is a condition in which decreased blood flow to brain tissue causes it to soften up and eventually die, leaving behind cysts filled with fluid. Over time, these cysts may fuse together or collapse altogether. The affected brain tissue and the nerve fibers that run through it help to control body movement; their loss will have an impact on this ability. Risk factors for PVL include moderate and severe IVH, infections within the womb, asphyxia, and a lengthy resuscitation following birth.
|Published (Last):||14 January 2006|
|PDF File Size:||14.91 Mb|
|ePub File Size:||5.20 Mb|
|Price:||Free* [*Free Regsitration Required]|
It is important to note that both periventricular and subcortical leukomalacia corresponds to a continuous disease spectrum. Please refer to the article on patterns of neonatal hypoxic-ischemic brain injury for a relation between perinatal brain maturation process and these lesions.
It likely occurs as a result of hypoxic-ischemic lesions resulting from impaired perfusion at the watershed areas, which in premature infants are located in a periventricular location. It is likely that infection or vasculitis also play a role in pathogenesis. The white matter necrosis often occurs in a characteristic distribution with the pattern being dorsal and lateral to the lateral ventricles and with the involvement of the centrum semiovale, the optic trigone and occipital horns and acoustic temporal horn radiations.
Cranial ultrasound provides a convenient, non-invasive, relatively low-cost screening examination of the haemodynamically-unstable neonate at the bedside. The examination also imparts no radiation exposure.
Sonography is sensitive for the detection of hemorrhage, periventricular leukomalacia, and hydrocephalus. On ultrasound, hyperechoic areas are firstly identified in a distinctive fashion in the periventricular area, more often at the peritrigonal area and in an area anterior and lateral to the frontal horns periventricular white matter should be less echogenic than the choroid plexus.
These are watershed areas that are sensitive to ischemic injury. Follow-up scans in the more severely affected patients may reveal the development of cysts in these areas, known as cystic PVL when cystic PVL is present, it is considered the most predictive sonographic marker for cerebral palsy. See sonographic grading of PVL.
Subsequent cavitation and periventricular cyst formation, features that are required for a definitive diagnosis of PVL, develop weeks after injury and are easily seen on sonograms as localized anechoic or hypoechoic lesions. Progressive necrosis of the periventricular tissue with resulting enlargement of the ventricles is called end-stage PVL. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait.
Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Log in Sign up. Articles Cases Courses Quiz. About Blog Go ad-free. As of the latest update, Google Chrome and Microsoft Edge have made a breaking change to how file uploads are handled. Once your system installs this update, you will not be able to upload new images. Please use another browser until we can get it fixed.
On this page:. Neonatal hypoxic-ischemic encephalopathy: multimodality imaging findings. Promoted articles advertising. Edit article Share article View revision history Report problem with Article.
URL of Article. Article information. Systems: Central Nervous System , Paediatrics. Support Radiopaedia and see fewer ads. Cases and figures. Case 2 Case 2. Case 3 Case 3. Case 5 Case 5. Case 6 Case 6. Case 8 Case 8. Case 9 Case 9. Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
Loading Stack - 0 images remaining. By System:. Patient Cases. Contact Us.
Introduction: There is a huge disparity in the description of the prevalence and risk factors of periventricular leukomalacia in preterm infants. Aims: To describe and compare, through a systematic review of the literature, the prevalence of periventricular leukomalacia in preterm infants, as well as to determine the main risk factors associated with its presentation. Subjects and methods: A systematic review was conducted consulting multiple databases of the last 20 years. The search terms were: periventricular leukomalacia, prevalence, risk factors and premature birth. We included all studies that mention or led to the prevalence of periventricular leukomalacia and those that referred to its risk factors. Results: Of the studies identified, we selected studies in which the prevalence of periventricular leukomalacia was mentioned or the risk factors were described. A stratified analysis was performed for the diagnostic technique and gestational age, in addition to a narrative synthesis.
Periventricular leucomalacia and neurodevelopmental outcome in preterm infants.
It is important to note that both periventricular and subcortical leukomalacia corresponds to a continuous disease spectrum. Please refer to the article on patterns of neonatal hypoxic-ischemic brain injury for a relation between perinatal brain maturation process and these lesions. It likely occurs as a result of hypoxic-ischemic lesions resulting from impaired perfusion at the watershed areas, which in premature infants are located in a periventricular location. It is likely that infection or vasculitis also play a role in pathogenesis. The white matter necrosis often occurs in a characteristic distribution with the pattern being dorsal and lateral to the lateral ventricles and with the involvement of the centrum semiovale, the optic trigone and occipital horns and acoustic temporal horn radiations.
Periventricular leucomalacia (PVL)
Periventricular leukomalacia PVL is a form of white-matter brain injury, characterized by the necrosis more often coagulation of white matter near the lateral ventricles. Affected individuals generally exhibit motor control problems or other developmental delays, and they often develop cerebral palsy or epilepsy later in life. This pathology of the brain was described under various names "encephalodystrophy", "ischemic necrosis", "periventricular infarction", "coagulation necrosis", "leukomalacia," "softening of the brain", "infarct periventricular white matter", "necrosis of white matter", "diffuse symmetrical periventricular leukoencephalopathy" , and more often by German scientists, but the worldwide dissemination was the term periventricular leukomalacia , introduced in B. Banker and J. The term can be misleading, as there is no softening of the tissue in PVL.