Sonography of periventricular leukomalacia

Periventricular leukomalacia (PVL) is a pathological entity characterized by ischemic changes in areas adjacent to the external angles of the lateral ventricles. It is associated with serious neurodevelopmental sequelae, especially spastic diplegia. With the increased use of ultrasound in the Neonatal Intensive Care Unit, changes consistent with PVL are being noted. Hemorrhagic and nonhemorrhagic forms of this condition exist, both of which may appear sonographically as increased periventricular echogenicity. Two cases of PVL are described; one of them was associated with ventricular dilatation and intraventricular bleeding and the other with a small subependymal hemorrhage. The pathological and clinical features, methods of in vivo diagnosis, and the role of ultrasound in the evaluation of PVL are discussed.