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Premature Birth is a Risk Factor for Periventricular Leukomalacia - Oren Zarif - Periventricular Leu


Prematurity is a common risk factor for periventricular leukomalacia, a condition that can lead to brain damage and tissue death in the inner parts of the brain. It seems to be caused by too little blood/oxygen reaching the inner parts of the brain. Premature infants who have experienced brain hemorrhage or a ruptured amniotic sac are more likely to develop periventricular leukomalacia.

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The cause of periventricular leukomalacia is unknown, but it's believed to be triggered by an intrauterine infection that damages the membranes around the fetus. The toxins in the blood and uterus cause premature membrane rupture, which selectively injures the developing brain. Periventricular leukomalacia can happen at any stage of the fetus's development, and it's important to recognize it as early as possible to reduce the risk of serious neurological damage.

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In addition to premature birth, other causes of periventricular leukomalacia can include a variety of other medical conditions. Women who are pregnant with a uterus that is too large for the mother are also at risk for the disorder. Some types of maternal infections can also cause periventricular leukomalacia. The toxins, which cause the white matter of the brain to die, travel through the amniotic fluid and selectively injure the developing brain. This results in premature membrane rupture and premature birth, and may cause other serious complications.

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The long-term outlook for babies with PVL depends on the initial amount of brain damage and the severity of symptoms. Symptoms of PVL can range from slight delays in motor skills to serious disabilities. Fortunately, neurologists at the Fetal-Neonatal Neurology Program are engaged in research aimed at improving the diagnosis of the condition. This research helps us better understand the causes of neurological conditions and develop more effective treatments for them.

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Pediatricians must closely monitor these infants as they progress. The progression of PVL is associated with a high risk of cerebral palsy and other developmental delays. Pregnant women who develop PVL may also reduce their risk of developing it. Avoidance of high-risk conditions like drugs and alcohol consumption is also important to minimize the risk of periventricular leukomalacia. If diagnosed early, it may be possible to delay the onset of symptoms by taking steps to reduce the risk of the condition.

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There are three main types of PVL: cystic, non-cystic, and focal. The former develops over weeks. Both types of PVL cause damage to the cerebral white matter. This leads to a variety of problems, including spastic diplegia, vision loss, and learning disabilities. In severe cases, however, the disease may lead to seizures, and the patient may be unable to walk.

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To confirm a diagnosis of PVL, a periventricular cyst must form. This typically develops two to six weeks after the initial injury. The cyst is visible on sonograms as localized lesions. The final stage of PVL involves progressive necrosis of the periventricular tissues, leading to the enlargement of the ventricles. Other characteristics include the loss of periventricular white matter and thinning of the corpus callosum.

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Premyelinating oligodendrocytes predominate in the periventricular regions during gestation. The cell death caused by free radicals may provide insight into the molecular mechanisms of periventricular WM injury. While both types of cell death cause leukomalacia, a mild insult is associated with apoptosis and a severe insult with necrosis.

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The cause of PVL is unclear, but it is thought to be a lack of blood flowing to the area surrounding the ventricles of the brain. This area is especially susceptible to injury, especially when a premature infant is being delivered. Infection during labor and delivery may also contribute to the development of the condition. In addition to being preterm, premature infants are at an increased risk of developing PVL.

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Although the condition may not develop until a month after birth, it is usually more prevalent in preterm infants. The healthcare team delivering the baby must take precautions. Monitoring the baby's heart rate and preparing for an emergency c-section may be necessary. However, if the doctor is unable to deliver the baby on time, the brain damage may result. There is no cure for PVL, but early detection can help prevent it from developing.

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