Periventricular Leukomalacia - Oren Zarif - Periventricular Leukomalacia

Periventricular leukomalacia (PVL) is a condition where there is damage to the white matter of the brain. This is the part of the brain that transmits information between the nerve cells and spinal cord. When damaged, the brain can no longer transmit information properly, resulting in a variety of symptoms. Symptoms of PVL may vary from minimal to severe, and they can affect movement or learning. The long-term outlook for a baby with this condition depends on the severity of initial brain damage and other factors. Fortunately, treatment options for PVL are increasingly effective, and we are continually researching new treatments to improve the lives of babies with this condition.

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The periventricular leukomalacia syndrome has numerous antecedents and is associated with a variety of symptoms. It usually affects an immature brain over a short gestational span.

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There is a wealth of information available about the disease's clinical antecedents and how it manifests on imaging. In addition to being associated with a combination of inflammation, periventricular leukomalacia is associated with high signal intensity on T2-weighted imaging, but low signals are seen on T1-weighted images.

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When a baby suffers from PVL, the white matter of the brain is damaged. The white matter is responsible for transferring nerve impulses from the brain's gray matter. Damage to the white matter reduces its function, and the brain's lateral ventricles fill with fluid, resulting in spasticity, intellectual disability, and vision problems. PVL can be prevented with early diagnosis and treatment.

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Symptoms of PVL vary from baby to baby, but it is common in preemies. Oftentimes, the cause is a lack of oxygen or blood flow. The brain tissue eventually deteriorates and becomes soft. Those babies with PVL should have regular checkups by a doctor as soon as possible. So, how is PVL diagnosed? What are the risks? PVL can lead to vision impairment, delayed mental development, and motor disorders.

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The incidence of cystic PVL in preterm infants has decreased to less than 3%, although more than 60% of children with cystic PVL develop cerebral palsy. Conventional T1 and T2-weighted MRI scans can detect cystic lesions. The most common location of cysts is in the centrum semiovale. Different types of cysts are associated with distinct patterns of diffusion.

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PVL is a result of a lack of oxygen or blood flow to the brain. This decrease in blood flow can lead to damage to the glial cells that support the neurons throughout the nervous system. In infants, glial cells are likely to interact. Eventually, these cells can die and the space within them will fill with fluid. Symptoms may not be apparent for months or years after birth.

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Among periventricular leukomalacia causes, maternal/fetal infection may contribute to the loss of OLs in PVL. Microglia, a subtype of neurons, are over-expressed in PVL, which likely contributes to the loss of premyelinating oligodendroglia. The inflammatory response in PVL causes inflammation and cell death in the periventricular region.