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Morphologic variations in periventricular leukomalacia.

R W Leech, E C Alvord

    The American Journal of Pathology
    |March 1, 1974
    PubMed
    Summary
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    This study identified three new forms of periventricular leukomalacia (PVL) in infant brains. These PVL variations may lead to widespread white matter loss and potential cognitive impairment in survivors.

    Area of Science:

    • Neuropathology
    • Neonatal Neurology
    • Pediatric Brain Development

    Background:

    • Periventricular leukomalacia (PVL) is a common neonatal brain injury.
    • Typically characterized by focal necrosis in the deep periventricular white matter.
    • Understanding PVL morphology is crucial for predicting outcomes.

    Purpose of the Study:

    • To investigate the diverse morphological presentations of PVL.
    • To identify potential new variants of PVL beyond typical descriptions.
    • To correlate PVL morphology with potential long-term neurological sequelae.

    Main Methods:

    • Examination of 116 infant brains using oil red O staining on frozen sections.
    • Identification and classification of PVL lesions based on morphology.

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  • Analysis of lesion distribution and characteristics.

    • Main Results:

    • Twenty-five cases of PVL were identified with typical coagulation necrosis.
    • Three distinct morphological varieties of PVL were demonstrated.
    • Lesions varied in extent, from periventricular to diffuse cerebral white matter involvement, with some showing subcortical extension.

    Conclusions:

    • The study identified novel PVL morphologies, including extensive and linear necrotic zones.
    • These less localized forms of PVL may be associated with diffuse white matter loss.
    • Such diffuse injury could increase the risk of mental retardation in surviving children.