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White Matter Injury of Prematurity
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Abbreviations

            • Periventricular leukomalacia (PVL)
          • Synonyms

            • White matter (WM) injury of prematurity, perinatal white matter damage, punctate WM lesions
          • Definitions

            • Perinatal WM injury occurring before 34 weeks gestation
              • Affected WM not always periventricular/deep

          IMAGING

          • 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

                                        1. Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
                                        2. 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
                                        3. Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
                                        4. Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
                                        5. de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
                                        6. 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
                                        7. van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
                                        8. 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
                                        9. 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
                                        10. 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
                                        11. 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
                                        12. Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
                                        13. Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
                                        14. O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
                                        15. Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
                                        16. 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

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Periventricular leukomalacia (PVL)
                                                • Synonyms

                                                  • White matter (WM) injury of prematurity, perinatal white matter damage, punctate WM lesions
                                                • Definitions

                                                  • Perinatal WM injury occurring before 34 weeks gestation
                                                    • Affected WM not always periventricular/deep

                                                IMAGING

                                                • 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

                                                                              1. Benders MJ et al: Neuroimaging of white matter injury, intraventricular and cerebellar hemorrhage. Clin Perinatol. 41(1):69-82, 2014
                                                                              2. 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
                                                                              3. Kwon SH et al: The role of neuroimaging in predicting neurodevelopmental outcomes of preterm neonates. Clin Perinatol. 41(1):257-83, 2014
                                                                              4. Shevell A et al: Chorioamnionitis and cerebral palsy: lessons from a patient registry. Eur J Paediatr Neurol. 18(3):301-7, 2014
                                                                              5. de Vries LS et al: Value of sequential MRI in preterm infants. Neurology. 81(24):2062-3, 2013
                                                                              6. 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
                                                                              7. van Haastert IC et al: Decreasing incidence and severity of cerebral palsy in prematurely born children. J Pediatr. 159(1):86-91.e1, 2011
                                                                              8. 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
                                                                              9. 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
                                                                              10. 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
                                                                              11. 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
                                                                              12. Shatrov JG et al: Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol. 116(2 Pt 1):387-92, 2010
                                                                              13. Hagberg H et al: Effect of inflammation on central nervous system development and vulnerability. Curr Opin Neurol. 18(2):117-23, 2005
                                                                              14. O'Shea TM et al: Magnetic resonance and ultrasound brain imaging in preterm infants. Early Hum Dev. 81(3):263-71, 2005
                                                                              15. Partridge SC et al: Diffusion tensor imaging: serial quantitation of white matter tract maturity in premature newborns. Neuroimage. 22(3):1302-14, 2004
                                                                              16. 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