Magnetic resonance imaging of periventricular leukomalacia and its clinical correlation in children

Abstract

The prevalence of periventricular leukomalacia and its association with clinical neurological signs in school-age preterm children are unknown. We matched 42 eight-year-old children who were born before term with birth weights lower than 1,750 gm (mean, 1,410 gm; gestational age, 31 weeks) with 42 children who were born at term and of normal birth weight, to compare clinical neurological status and magnetic resonance imaging findings. Of the children born prematurely, 9.5% had cerebral palsy and 31% had minor neurological dysfunction whereas 9% of the children born at term had minor neurological dysfunction and none had cerebral palsy. Deviations in tongue movements, heel walking. Fogs test results, and finger opposition, as well as behavioral disturbances, differentiated the preterm from the full-teem group. The prevalence of periventricular leukomalacia among all children born prematurely was 32%. It was observed in all children with cerebral palsy, in 25% with minor neurological dysfunction, and in 25% of the clinically healthy preterm children. None of the children born at term had evidence of periventricular leukomalacia. Children with periventricular leukomalacia especially demonstrated poor performance on heel walking and Fogs test. Though commonly found in preterm children, periventricular leukomalacia is not uniformly associated with abnormal neurological findings. A thorough neurological examination is a better predictor of later developmental problems than is magnetic resonance imaging.

Periventricular Leukomalacia with Late-Onset Circulatory Dysfunction of Premature Infants: Correlation with Severity of Magnetic Resonance Imaging Findings and Neurological Outcomes

“…The significant difference in gestational age between the groups in the present study might affect our findings. However, the severity of MRI findings with PVL was not associated with smallness of gestational age (Olsen et al 1997). Ventriculomegaly and the reduction in white matter did not differ between PVL patients over and under 28 weeks of gestational age .…”

Pontine Hypoplasia in Children with Periventricular Leukomalacia

“…2 On MR imaging, the characteristic findings of PVL include volume loss of the white matter, associated with ventriculomegaly with irregular margin, cystic change, periventricular hyperintensity on T2-weighted images, and a thin corpus callosum. 3,4 These are the results of white matter cavitation, loss, and gliosis. 5 Although PVL is a form of deep white matter injury leading to loss of periventricular and deep white matter volume, 2 its relationship to the development of white matter tracts is still unclear.…”

Subnormal visual perception in school-aged ex-preterm patients in a paediatric eye clinic

“…28,29 Lesions of the periventricular white matter visible by MRI are common in children who were born prematurely and PVL is also reported to be common in apparently healthy preterm children. [30][31][32][33] Few studies have been conducted on the visual functions of children with PVL in the absence of CP. It seems likely that many of these children are not identified as having PVL, as few children who do not have CP undergo CT or MRI.…”