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  • Writer's pictureOren Zarif

Periventricular Leukomalacia - Oren Zarif - Periventricular Leukomalacia

The underlying cause of periventricular leukomalacia (PVL) is decreased blood flow. The risk of developing this condition is higher in infants under 32 weeks of gestation, especially those born prematurely. Other causes include certain types of maternal infections, and a premature birth. Ultimately, periventricular leukomalacia is a condition that should be diagnosed and treated as soon as possible.

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Because premature babies do not have the ability to regulate blood flow, they may suffer hemorrhage. This insufficient blood can injure the developing brain, resulting in a variety of symptoms. The spine, ears, and eyes are also vulnerable to this condition, depending on the location of the injury. In some cases, acidosis or hypocarbia is also a risk. These conditions can be life-threatening for the baby and need immediate medical attention.

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PVL is a potentially fatal condition, and the prognosis for a baby with PVL is dependent upon the severity of the damage to the brain. Infants born prematurely may have minimal to severe delays in learning, and movement. A neonatologist in the Fetal-Neonatal Neurology Program is dedicated to research to understand neurological conditions like periventricular leukomalacia and develop more effective treatments.

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Periventricular leukomalacia is the most common neuropathologic form of brain injury in premature infants, and it accounts for the majority of neurologic morbidity of these children. Recent neurobiologic insights into its pathogenesis have made it possible to develop effective treatment options. These therapies target three major factors that contribute to the development of PVL. The first is incomplete development of cerebral white matter and a maturation-dependent impairment of cerebral blood flow.

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The symptoms of periventricular leukomalacia are difficult to detect in newborns. Most babies do not display any symptoms and are not diagnosed until months after birth. Most common symptoms are mild to moderate cognitive impairment, such as cerebral palsy, which results in stiff muscles in the legs. Further symptoms can include developmental and learning disabilities, visual problems, and spastic diplegia. Treatment is available, and patients can improve their quality of life.

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The diagnosis of PVL requires a comprehensive medical examination. A cranial ultrasound, CT scan, and MRI can help identify the condition. Treatment may involve therapeutic hypothermia and other measures. Fortunately, it can be prevented in pregnant women. To minimize the risk of developing PVL, expectant mothers should avoid high-risk conditions, such as infections and alcohol abuse. Additionally, they should be closely monitored for any major health problems and seek proper diagnosis.

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The white matter surrounding the brain is composed of cells and fibers that control a variety of functions. It is composed of fatty substance called myelin. If this protective material breaks down, it prevents the transmission of nerve impulses and impairs brain functions. The brain can suffer severe disabilities in children with periventricular leukomalacia. It also increases the risk of Cerebral palsy.

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In early differentiating OLs, the cellular damage from free radicals is the most likely cause of periventricular leukomalacia. However, while the OLs in PVL may be depleted by apoptosis, the WM also undergoes damage via an inflammatory process called necrosis. The inflammatory response to bacterial infections and endotoxins has been implicated in PVWM.

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The risk of cerebral palsy in infants with PVL is increased. Between 60% and 100% of babies will be diagnosed with this disorder. Although the exact cause of PVL is unknown, lack of oxygen and blood flow to the brain area has been linked with the condition. The risk of PVL is even higher in premature infants if a physician fails to perform an emergency C-section. The symptoms of this condition may manifest gradually.

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