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Updated: Aug 4, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
The evolution and outcome of cavitating periventricular leukomalacia in infancy. A study of 46 cases
D Shortland1, M I Levene, J Trounce
1Department of Child Health, Leicester University School of Medicine, Great Britain.
Insights
Cavitating periventricular leukomalacia (CPVL) in premature infants is linked to significant neurodevelopmental handicap, especially cerebral palsy. Lesion location and size are key predictors of CPVL complications.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
- Developmental pediatrics
Background:
- Cavitating periventricular leukomalacia (CPVL) is a severe form of white matter injury in premature infants.
- Ultrasound is a primary diagnostic tool for identifying CPVL and monitoring its progression.
- CPVL is associated with adverse neurodevelopmental outcomes, but specific predictors require further elucidation.
Purpose of the Study:
- To correlate ultrasound findings of CPVL with subsequent neurodevelopmental and neurological deficits in infants.
- To identify risk factors and specific patterns of CPVL that predict cerebral palsy and handicap.
- To assess the relationship between CPVL characteristics and the incidence of severe developmental delay.
Main Methods:
- Retrospective review of 46 infants diagnosed with CPVL via ultrasound.
- Correlation of ultrasound imaging features (cavity location, size) with follow-up neurodevelopmental assessments.
- Analysis of factors predicting cerebral palsy, including lesion characteristics and gestational age.
Main Results:
- CPVL occurred in 15% of very premature infants (≤27 weeks gestation) surviving ≥14 days.
- Cavities developed median 15 days post-echodensity; 24% showed ventricular dilatation.
- Of 27 infants with follow-up, 67% had significant neurodevelopmental handicap; cerebral palsy was strongly linked to cavities.
- Predictors of cerebral palsy included occipital cavities, multiple affected brain regions, lesions >1 cm, and association with subcortical leukomalacia.
Conclusions:
- Specific CPVL characteristics, particularly occipital involvement and larger lesion size, are significant predictors of cerebral palsy.
- While CPVL is linked to handicap, cavities alone do not strongly predict severe developmental delay.
- Ultrasound-based assessment of CPVL lesion patterns aids in predicting neurological deficits and guiding clinical management.
Abstract:
Forty six infants with the ultrasonic diagnosis of cavitating periventricular leukomalacia (CPVL) have been reviewed. Follow up examination results allow correlation between the ultrasound appearances and subsequent neurodevelopmental and neurological deficits. The highest incidence of this condition was found in infants at and below 27 weeks gestation, and occurred in 15% of very premature infants surviving 14 days or more. Cavities developed 15 days after the onset of periventricular echodensity (median time). Ventricular dilatation occurred in 24% of the infants who developed cavities. Follow up information was available in 27 infants and 18 of these (67%) had significant neurodevelopmental handicap. The location of echolucent cavities were described as involving anterior, middle or posterior cerebral zones or any combination of these. Cerebral palsy was closely related to the presence of cavities, but there was little association between cavities and developmental delay. Four factors were found to predict cerebral palsy: cavities within the occipital zone, the involvement of multiple regions of the brain, lesions greater than 1 cm in diameter and cavities associated with subcortical leukomalacia. Lesions confined to the anterior or middle zones were unlikely to be associated with significant handicap. The presence of cavities per se was not associated with a higher incidence of severe developmental delay.
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