Abstract
Portable cranial sonography was done on 389 infants with birth weights of 1750g or less admitted to Georgetown University Hospital's Intensive Care Nursery during the 3-year period May 1981 to April 1984. Periventricular leukomalacia(PVL) was diagnosed in 28 infants (7.2%) with birthweights of 680-1730g with appropriate gestational ages 26-33 weeks. The lesions were bilateral in 89% and widespread along the ventricular borders in 86%. Survival in the PVL group was 75%, statistically not significant from 83% on infants without PVL.
Twenty of the 21 PVL survivors have been evaluated quarterly using the Bayley Scales of Motor (PDI) and Mental(MDI) Development and standard neurological criteria. All infants demonstrated generalized hypertonia/spasticity on follow-up to 6-35 months (mean 17.6 months). Ninety percent had severe motor deficits, and 75% had significant delay in mental scores (MDI). Cortical blindness was present in 25%. The infants with significantly abnormal MDI and PDI (scores<50) all had bilateral widespread PVL, in contrast to the infants within the normal range who demonstrated focal and/or unilateral lesions.
Conclusions: 1)PVL occurs in 7.2% of premature infants weighing 1750g or less at birth; 2) significant neuro-developmental handicaps are present in infants with bilateral widespread PVL; and 3) infants with focal and/or unilateral lesions have a better chance for reasonable developmental outcome.
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Smith, Y., Young, M., Sostek, A. et al. 1707 PERIVENTRICULAR LEUKOMALACIA: INCIDENCE AND SIGNIFICANCE IN PREMATURE INFANTS. Pediatr Res 19, 395 (1985). https://doi.org/10.1203/00006450-198504000-01725
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DOI: https://doi.org/10.1203/00006450-198504000-01725