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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
- 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