Neurosonographic and Biochemical Correlates of Periventricular Leukomalacia in Low-Birth-Weight Infants

Amato, M.; Gambon, Reto; Muralt, G. Von; Huber, P

doi:10.1159/000120308

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…The morphological patterns of PVL commonly represent more or less symmetrical periventricular lesions associated with spastic diplegia (10,25,61). However, the lesions consistent with PVL found in our hemiplegic children were more asymmetrical and in most cases purely unilateral, a feature previously reported (2,12,13,26,32,44). Although some authors have discussed PVL as a possible cause ef hemiplegia, the specific diagnosis of PVL was not made, maybe because the CT appearance of PVL had not been described at that time (20).…”

Section: Discussionsupporting

confidence: 64%

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy; II: Children Born at Term

1991

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CT brain scans were used to evaluate the most likely etiology of hemiplegic cerebral palsy in a group of children born at term. The population based study group comprised 83 children. The CT findings were classified to reflect the phase of brain maturation during which the injury causing hemiplegia most likely had occurred. The most common finding (37%) was periventricular atrophy considered to represent periventricular leukomalacia (PVL). PVL is a form of hypoxic-ischemic damage typical of the immature brain and most commonly seen as a complication of preterm birth. As this lesion was found in children born at term it was considered to reflect a cerebral injury that had occurred in utero. Cerebral maldevelopment, due to a very early intrauterine lesion, was detected in 17%, while cortical-/subcortical lesions, previously considered to be of major importance in hemiplegia, were seen in just 16% of the children. Altogether the CT findings indicated a prenatal origin of hemiplegia in 57%. Assessing the time of injury based on clinical records concurred with prenatal origin in 32% of the children thought to have prenatal origin of hemiplegia by CT. The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. We propose that assessment of brain morphology, by means of imaging, should be integrated with clinical assessment when evaluating the etiology of brain lesions in children with congenital motor impairment.

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Section: Discussionsupporting

confidence: 64%

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy; II: Children Born at Term

1991

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“…Commonly, PVL is a bilateral lesion thought to be responsible for most eases of spastie diplegia in ehildren born preterm (3,20,48). However, PVL has also been reported as an asymmetrieal or unilaterallesion (1,22). We found three patients in our series who proved to have bilateral abnormalities typieal for PVL (Fig.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy - I: Children Born Preterm

Uvebrant

Flodmark

1991

Neuropediatrics

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Computed tomography (CT) of the brain has been used to evaluate potential etiologies of hemiplegic cerebral palsy in a population-based group of 28 children born preterm, in whom an obvious postnatal cause of hemiplegia could be excluded. The CT findings were classified according to a system so constructed to reflect the phase of brain maturation during which the insult causing hemiplegia likely had occurred. We found that 50% had evidence of periventricular leukomalacia the lesion typical of hypoxic-ischemic injury to the immature brain. However, it was not possible, neither from the CT scans nor from retrospective review of available clinical data, to date the injury more precisely to the pre- or perinatal period. Analysis of CT findings further showed that 18% of the children had cerebral maldevelopment, indicating an injury during early fetal life as the cause of hemiplegia, earlier than clinically suspected. The CT scans were normal in 25% of the children. It is concluded that the objective information obtained by studying the morphology of brain lesions using CT provides important information in addition to clinical data, and should be integrated with clinical assessment when attempts are being made to evaluate the etiology of cerebral palsy in children.

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“…Walther et al [ 17] demonstrate a 6% decrease of cardiac output probably due to reduced stroke volume during PT [14], Because PT simulta neously increases peripheral blood flow and decreases car diac output, the present study was aimed to delineate variations in CBF in clinically healthy preterm babies receiving PT for jaundice. Low-birth-weight infants are at prime risk of neurodevelopmental sequelae, and prema turity appears a critical risk factor for hemorrhagic or ischemic lesions due to poor CBF autoregulation [1,2], The Doppler technique of detecting CBF has found many applications in clinical science and is nowadays a good noninvasive means of obtaining accurate blood flow measurements in neonates [8], Fluctuating pattern of CBF velocity may predispose an infant to peri-intraventricular hemorrhage or periventricular leukomalacia [15,16]. The major disadvantage of using the Doppler technique is that no quantitative measure of CBF can be obtained.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamics in Low-Birth-Weight Infants Treated with Phototherapy

Amato¹,

Donati²,

Markus³

1991

Eur Neurol

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Changes of cerebral blood flow were determined in 20 preterm infants undergoing blue-light phototherapy for hyperbilirubinemia. All were healthy very-low-birth-weight infants (< 1,500 g) with normal brain sonograms and not under pharmacological treatment at the time of the investigation. Blood flow velocity (pulsatility index and area under velocity curve) was measured by Duplex Scan technique during and after phototherapy. No changes of global cerebral blood flow were observed in the anterior cerebral artery (p < 0.5). Our results suggest no functional disturbance of cerebral autoregulation in low-birth-weight infants treated with phototherapy.

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Neurosonographic and Biochemical Correlates of Periventricular Leukomalacia in Low-Birth-Weight Infants

Cited by 7 publications

References 23 publications

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy; II: Children Born at Term

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy; II: Children Born at Term

Computed Tomography as an Adjunct in Etiological Analysis of Hemiplegic Cerebral Palsy - I: Children Born Preterm

Cerebral Hemodynamics in Low-Birth-Weight Infants Treated with Phototherapy

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