Pathogenesis of periventricular white matter hemorrhages in preterm infants

Deep Medullary Vein Involvement in Neonates with Brain Damage: An MR Imaging Study

“…In 10 cases, they were associated with GMH and/or periventricular hematoma. According to these data and to other published pathology studies, 8,18,19 we may assume that isolated DMV lesions, GMH, and PH may represent different stages of a common pathologic process related to cerebral vascular immaturity.…”

“…A similar condition may occur during prenatal life, as reported by a recent work, 20 in which central venous hypertension was considered responsible for brain damage associated with DMV involvement in fetuses with circulatory heart failure. Moreover, pathology studies 8,18 confirm that DMV thrombosis may be associated with perivenular hemorrhage in premature neonates.…”

“…[7][8][9][10] Superficial veins are small short vessels that originate 1-2 cm below gray matter, run in a ventricolofugal way through the cortical layer, and drain into superficial pial veins. DMVs are longer and larger vessels that originate in the subcortical WM in the same areas as superficial veins, run in a ventricolopetal way to the ventricular surface, and drain into subependymal veins.…”

Ultrasonographic Differential Diagnosis and Neurodevelopmental Outcome of Cerebral White Matter Lesions in Premature Infants

“…2 This association has led to the hypothesis that the IVH compresses the terminal vein draining the periventricular white matter resulting in a venous infarction. [3][4][5] PVL is a bilateral, nonhemorrhagic cystic white matter lesion commonly associated with subsequent spastic motor and cognitive deficits. 6,7 The pathogenesis of PVL has been attributed to arterial hypotension, which causes focal ischemia and ensuing development of cysts at arterial "watershed" areas.…”

Indices of Hemodynamic and Respiratory Functions in Premature Infants at Risk for the Development of Cerebral White Matter Injury

“…1 -3 Theories on the pathogenesis of PHI stress the importance of the presence of an ipsilateral intraventricular hemorrhage that obstructs the periventricular venous drainage leading to a unilateral, or markedly asymmetric, venous infarction. 4,5 In contrast, PVL is considered by many to be an ischemic lesion resulting in small, multiple, bilateral, periventricular cysts typically in arterial watershed areas. 6 -8 Despite a great deal of experimental and clinical research supporting pathogenetic differences between PHI and PVL, a growing body of data suggests that these two white matter lesions are different manifestations of a more global brain injury.…”