J Korean Soc Neonatol.  2000 Nov;7(2):145-153.

Cystic Periventricular Leukomalacia: Clinical Features in the Development and Neurologic Outcome

• Kim CS
• Lee SL
• Kim JS

Abstract

PURPOSE
Cystic periventricular leukomalacia (PVL) remains a significant problem in the premature infant, despite recent advances in neonatal intensive care. This study was undertaken to investigate clinical features in the development and neurologic outcome of cystic PVL.
METHODS
This study involved 24 newborn infants with cystic PVL on brain ultrasonography who were admitted to Dongsan Medical Center between Jan. 1993 and Aug. 1997. We investigated sex ratio, development rate according to gestational age or birth weight, occurrence sites, risk factors and neurologic sequelae related to cystic PVL.
RESULTS
Most cases with cystic PVL were premature infants. The incidence of cystic PVL was 4.5% in babies less than 32 weeks gestational age, 4.6% in babies less than 1,500 g birth weight and 1.3% in all premature babies. Among 24 cases, 22 cases had bilateral lesions and 2 had unilateral lesion. Two cases among 15 extensive lesions showed expansion of lesion to subcortical white matter and 5 showed microcystic PVL among 9 localized lesions. Occurrence sites of 9 localized lesions were frontal area in 2, parietal area in 5 and occipital area in 2. Neurologic outcome of children with cystic PVL showed cerebral palsy : 68.2%, normal development : 22.7%, epilepsy and hearing defect 9.1%, motor disturbance and visual defect : 4.5% respectively. Types of cerebral palsy showed spastic diplegia : 66.7%, spastic quadriplegia : 20%, spastic hemiplegia and mixed form : 6.7% respectively. Cerebral palsy and other neurologic sequelae developed more highly in extensive or bilateral cystic PVL.
CONCLUSION
Most children with cystic PVL had development of cerebral palsy or other neurologic deficit. Thus estabilishment of adequate follow-up care program is needed to minimize neurologic sequelae and screening test for early diagnosis of cystic PVL in high risk newborn infants, for example very low birth weight infant.

Keyword

Cystic PVL; Premature infant; Cerebral palsy

MeSH Terms

Birth Weight
Brain
Cerebral Palsy
Child
Early Diagnosis
Epilepsy
Follow-Up Studies
Gestational Age
Hearing
Hemiplegia
Humans
Incidence
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Leukomalacia, Periventricular*
Mass Screening
Neurologic Manifestations
Quadriplegia
Rabeprazole
Risk Factors
Sex Ratio
Ultrasonography