Early diffusion-weighted images in infants with subcortical leukomalacia

We describe two infants with subcortical leukomalacia and decreased water diffusivity in widespread white matter on magnetic resonance imaging. In both infants, diffusion-weighted imaging at age 1 day revealed a widespread increase in signal intensities, predominantly in subcortical areas. The corticospinal tract in the brainstem was not involved. Subsequently, diffusion-weighted imaging produced apparently normal results, and conventional magnetic resonance imaging indicated diffuse but subcortical-dominant white matter lesions in the subacute phase. Follow-up magnetic resonance imaging revealed a volume loss and gliosis of the white matter. In one infant, psychomotor development was mildly delayed, and epilepsy occurred. The other infant experienced normal development and no epilepsy. Neither infant developed spastic cerebral palsy. These infants represent a characteristic group with perinatal brain injury.