Perinatal WM injury occurring before 34 weeks gestation
Affected WM not always periventricular/deep
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Barnett ML et al: Exploring the multiple-hit hypothesis of preterm white matter damage using diffusion MRI. Neuroimage Clin. 17:596-606, 2018
Back SA: White matter injury in the preterm infant: pathology and mechanisms. Acta Neuropathol. 134(3):331-49, 2017
Lee YA: White Matter injury of prematurity: Its mechanisms and clinical features. J Pathol Transl Med. 51(5):449-55, 2017
Volpe JJ: Confusions in nomenclature: "Periventricular leukomalacia" and "white matter injury"-identical, distinct, or overlapping? Pediatr Neurol. 73:3-6, 2017
Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
Kendall GS et al: White matter NAA/Cho and Cho/Cr ratios at MR spectroscopy are predictive of motor outcome in preterm infants. Radiology. 271(1):230-8, 2014
Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
de Bruïne FT et al: Clinical implications of MR imaging findings in the white matter in very preterm infants: a 2-year follow-up study. Radiology. 261(3):899-906, 2011
van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
van Wezel-Meijler G et al: Ultrasound detection of white matter injury in very preterm neonates: practical implications. Dev Med Child Neurol. 53 Suppl 4:29-34, 2011
Volpe JJ et al: The developing oligodendrocyte: key cellular target in brain injury in the premature infant. Int J Dev Neurosci. 29(4):423-40, 2011
Kato A et al: Relationship between enlargement of the lateral ventricle and periventricular leukomalacia in infants. J Obstet Gynaecol Res. 36(5):984-90, 2010
Leijser LM et al: Is sequential cranial ultrasound reliable for detection of white matter injury in very preterm infants? Neuroradiology. 52(5):397-406, 2010
Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
Ment LR et al: Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 58(12):1726-38, 2002
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
White matter (WM) injury of prematurity
Synonyms
Periventricular leukomalacia (PVL)
Cystic PVL; noncystic PVL
Punctate WM lesions
Definitions
Perinatal WM injury occurring before 34 weeks gestation
Affected WM not always periventricular/deep
IMAGING
General Features
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Barnett ML et al: Exploring the multiple-hit hypothesis of preterm white matter damage using diffusion MRI. Neuroimage Clin. 17:596-606, 2018
Back SA: White matter injury in the preterm infant: pathology and mechanisms. Acta Neuropathol. 134(3):331-49, 2017
Lee YA: White Matter injury of prematurity: Its mechanisms and clinical features. J Pathol Transl Med. 51(5):449-55, 2017
Volpe JJ: Confusions in nomenclature: "Periventricular leukomalacia" and "white matter injury"-identical, distinct, or overlapping? Pediatr Neurol. 73:3-6, 2017
Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
Kendall GS et al: White matter NAA/Cho and Cho/Cr ratios at MR spectroscopy are predictive of motor outcome in preterm infants. Radiology. 271(1):230-8, 2014
Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
de Bruïne FT et al: Clinical implications of MR imaging findings in the white matter in very preterm infants: a 2-year follow-up study. Radiology. 261(3):899-906, 2011
van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
van Wezel-Meijler G et al: Ultrasound detection of white matter injury in very preterm neonates: practical implications. Dev Med Child Neurol. 53 Suppl 4:29-34, 2011
Volpe JJ et al: The developing oligodendrocyte: key cellular target in brain injury in the premature infant. Int J Dev Neurosci. 29(4):423-40, 2011
Kato A et al: Relationship between enlargement of the lateral ventricle and periventricular leukomalacia in infants. J Obstet Gynaecol Res. 36(5):984-90, 2010
Leijser LM et al: Is sequential cranial ultrasound reliable for detection of white matter injury in very preterm infants? Neuroradiology. 52(5):397-406, 2010
Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
Ment LR et al: Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 58(12):1726-38, 2002
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