Korean J Obstet Gynecol.  2012 Apr;55(4):257-260. 10.5468/KJOG.2012.55.4.257.

Prenatal diagnosis of cystic periventricular leukomalacia in a full term fetus

• Joo HJ
• Jeong HC
• Lee YJ
• Hwang JY
• Lee SH
• Kim DH
• Han SS
• Kim GJ

• KMID: 1992622
• DOI: http://doi.org/10.5468/KJOG.2012.55.4.257

Abstract

Periventricular leukomalacia is a disorder of white matter injury that is frequently found in premature infants and is the major cause of cerebral palsy. However, only a few cases of periventricular leukomalacia have been reported prenatally. Ultrasound investigation of the periventricular region could provide clues for the prenatal diagnosis and prediction of cerebral palsy. Herein, we report a case of cystic periventricular leukomalacia that was diagnosed prenatally and confirmed postnatally by brain magnetic resonance imaging.

Keyword

Periventricular leukomalacia; Cerebral palsy; Periventricular echodensities; Prenatal ultrasonogram

MeSH Terms

Brain
Cerebral Palsy
Fetus
Humans
Infant, Newborn
Infant, Premature
Leukomalacia, Periventricular
Magnetic Resonance Imaging
Prenatal Diagnosis

Figure

• 

  Fig. 1 Prenatal sonogram: Enlarged right lateral ventricle (white star) with periventricular cystic changes (white arrow).

• 

  Fig. 2 Postnatal brain magnetic resonance imaging: Cystic encephalomalacia (white arrow) with dilated right lateral ventricle (black star).

• 

  Fig. 3 Postnatal brain sonogram: Increased left periventricular echogenicity (white arrows), suggesting periventricular leukomalacia grade 1.

Reference

1. Folkerth RD. Periventricular leukomalacia: overview and recent findings. Pediatr Dev Pathol. 2006. 9:3–13.

2. Back SA. Perinatal white matter injury: the changing spectrum of pathology and emerging insights into pathogenetic mechanisms. Ment Retard Dev Disabil Res Rev. 2006. 12:129–140.

3. Rezaie P, Dean A. Periventricular leukomalacia, inflammation and white matter lesions within the developing nervous system. Neuropathology. 2002. 22:106–132.

4. Yamamoto N, Utsu M, Serizawa M, Ohki S, Murakoshi T, Seguchi M, et al. Neonatal periventricular leukomalacia preceded by fetal periventricular echodensity. Fetal Diagn Ther. 2000. 15:198–208.

5. Murata Y, Itakura A, Matsuzawa K, Okumura A, Wakai K, Mizutani S. Possible antenatal and perinatal related factor in development of cystic periventricular leukomalacia. Brain Dev. 2005. 27:17–21.

6. Funakoshi T, Ueda Y, Kobayashi A, Morikawa H, Mochizuki M. Studies on insulin-like growth factors (IGF-I, -II) and there binding proteins in normal human pregnancy. Nihon Naibunpi Gakkai Zasshi. 1990. 66:688–699.

7. Nitta A, Suzumura H, Kano K, Arisaka O. Congenital cystic periventricular leukomalacia in a small-for-gestational age full-term infant. Pediatr Int. 2008. 50:696–697.

8. Hagberg H, Peebles D, Mallard C. Models of white matter injury: comparison of infectious, hypoxic-ischemic, and excitotoxic insults. Ment Retard Dev Disabil Res Rev. 2002. 8:30–38.

9. Yoon BH, Romero R, Yang SH, Jun JK, Kim IO, Choi JH, et al. Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia. Am J Obstet Gynecol. 1996. 174:1433–1440.

10. Gilbert-Barness E, Kapur RP, Oligny LL, Siebert JR. Potter's pathology of the fetus, infant, and child. 2007. 2nd ed. Philadelphia (PA): Mosby Elsevier.

11. Resch B, Jammernegg A, Perl E, Riccabona M, Maurer U, Müller WD. Correlation of grading and duration of periventricular echodensities with neurodevelopmental outcome in preterm infants. Pediatr Radiol. 2006. 36:810–815.