What is Periventricular Leukomalacia?

Periventricular leukomalacia is a type of brain injury in which brain tissues are softened by the death of white matter; it affects both fetuses and newborn infants. Most babies do not exhibit any immediate symptoms of this white-matter injury, but common indicators that may later appear include an inability to cultivate basic motor skills, slowed mental development, seizures, and vision or auditory problems. Epilepsy or cerebral palsy often develop as the infant matures.

The growth of periventricular leukomalacia is initiated by two main factors. The periventricular section of the brain, which is comprised of the white matter located near the cerebral ventricles, loses oxygen or blood during the brain's development. When paired with damage to the cells that offer nervous system support, the conditions for periventricular leukomalacia are present. This set of circumstances is most predominant in premature babies, placing them at the greatest risk for periventricular leukomalacia.

The extent of periventricular leukomalacia is virtually impossible to determine during the early stages of an infant's life. Since impaired motor skills are a telltale sign, and all newborns possess limited motor skills, the illness can only be diagnosed by an ultrasound of the head. An ultrasound, however, may not immediately read the injury, and the more accurate magnetic resonance imaging (MRI) may be used.

Periventricular leukomalacia has varying degrees of severity, depending entirely upon the extent of damage to the brain tissues. Some infants may be unusually slow in various areas of physiological development, have low heart rates, or face problems with coordination and balance. In more severe cases, infants will develop major issues with motor functions or serious anomalies in organ maturity. Infants who fall into this latter category may one day become quadriplegic or acquire epilepsy or cerebral palsy.

Often referred to by the acronym PVL, periventricular leukomalacia has no corresponding treatment. The symptoms of the injury are treated on a case-by-case basis, and in most instances, doctors will monitor patients closely, owing to the sensitive nature of the nervous system and the multitude of complications that can arise. Treatment is further complicated by the fact that medications that work in adults with PVL can be detrimental to infants. The prognosis for individuals with PVL is contingent upon the severity of the injury.

Preventative measures are key in avoiding a diagnosis of PVL. The most common of these measures entails doing everything possible to prevent a premature birth, from proper nutrition and medications to bed rest. Appropriate prenatal care ensures the fetus's developmental progress will be monitored closely.