Periventricular leukomalacia

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Periventricular Leukomalacia (PVL) in children


– White Matter matter lesion

– Affects premature babies who have shock, hyaline membrane disease, and other complications of prematurity


- Bilateral, roughly symmetric foci of white matter necrosis develop around the lateral ventricles – Evolution similar to infarcts, i.e. liquefaction, phagocytosis, cavitation, and gliosis.

– At the calcified stage, the lesions appear as whitish spots in the periventricular white matter

– In the acute phase, the necrotic lesions can be detected by ultrasound because of their echogenicity

– Cysts appear in 2-4 weeks.

– Later, the cysts collapse and the lateral ventricles enlarge.

- Cortical ischemic lesions are also present in some cases

Clinical Features

- Children with PVL develop spastic diplegia or quadriplegia and mental retardation

Periventricular Leukomalacia (PVL) in adults

– markedly reduced white matter volume around the ventricles


- Often seen in aquired metabolic, white matter, and degenerative diseases but may also be seen in normal aging brain

- May be seen in hydrocephalus, multiple sclerosis, arteriosclerosis, postviral demyelination syndromes, alcoholic demyelination, inherited leukodystrophies, lead and mercury intoxciation, osmotic demyelination

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