Periventricular Leukomalacia
Periventricular leukomalacia (PVL) is a ischemic cerebral white matter disorder and occurs in the premature brain of about 24-35 weeks of gestation.29,38 In addition to arterial ischemia, other factors involved in the pathophysiology of these changes include immaturity of the brain, underdeveloped cerebral vasculature and nature of cell component such as intrinsic vulnerability of the oligodendroglia, hemorrhage during later pregnancy and perinatal period, vascular anastomosis in the placenta, and hypotension. Factors relating prenatal infections, such as chorioamnionitis, may also play a role through cytokines.29,37,38,40 Hypocapnia due to mechanical ventilation is one of the risk factors for ischemia.38
In acute phase neuro-sonography shows periventricular echodense and/or echolucent cystic lesion and in chronic phase MRI reveals signal changes or decreased volume of periventricular white matter.29,40 Reduction in cortical gray matter volume presumably secondary to axonal loss is also detected.41 Spastic diplegia is the main clinical outcome, often associated with epilepsy.40,42 Sprouting following axonal damage may result in reorganization of neuronal network and probably may contribute to the epileptogenicity.43
Average user rating: 5 stars out of 1 votes
Post a comment