Periventricular leucomalacia and intraventricular haemorrhage in the preterm neonate.

Abstract

SUMMARY Two hundred very low birthweight infants were prospectively scanned to ascertain the incidence of periventricular leucomalacia (PVL) whom had associated parenchymal-lesions. Haemorrhage, PVL, and flare occurred commonly in infants of 30 weeks' gestation and below and became markedly less common in more mature infants. We believe prolonged flare represents a form of PVL, and in this study a total of 52 (26%) infants had an ultrasound appearance of periventricular leucomalacia, an incidence considerably higher than previously reported.

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

“…Trounce et al . [11] reported that ultrasonic evidence of hemorrhage was evident within the first 7 days of life in 78% of neonates and 2 nd week in 15% neonates. In this study, 12% high-risk neonates have evidence of intracranial bleed (GMH, IVH) all of which were picked up between 24 and 72 h of life.…”

Elevated arterial blood pressure is associated with peri-intraventricular haemorrhage

“…The incidence of peri-intraventricular haemorrhage (PIVH) in infants below 1500 g in weight and below a gestational age of 36 weeks is between 26% and 55% [1,4,9,27,32], and the incidence of periventricular leucomalacia (PVL) is between 10% and 25% [16,17,21,34]. PIVH and PVL are associated with neurodevelopmental disorders and also with considerable mortality when intraparenchymal involvement is present [3,13,30,33].…”

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

“…[12][13][14] The characterization of PHVI and PVL was the result of careful neuropathologic studies and improvements in the quality and resolution of cranial ultrasonography. 15 Although there are detailed descriptions of specific ultrasonographic criteria for differentiating PHVI and PVL in preterm infants, 16,17 most studies do not attempt to make this distinction and choose to use the term "grade 4 IVH" or periventricular echodensity to describe white matter lesions. 18 -24 This hesitation to differentiate PHVI and PVL is understandable because both lesions are initially echogenic with later cystic evolution 19 and neuropathologic studies have documented hemorrhage into areas of periventricular ischemia, thus blurring the distinction between hemorrhagic and ischemic lesions.…”