Periventricular leukomalacia

From Wikipedia, the free encyclopedia

Periventricular leukomalacia Classification and external resources
ICD-10	P91.2
ICD-9	779.7
DiseasesDB	9868
eMedicine	ped/1773
MeSH	D007969

Periventricular leukomalacia (PVL) is characterized by the death of the white matter near the cerebral ventricles due to softening of the brain tissue. It can affect fetuses or newborns; premature babies are at the greatest risk of the disorder.

Contents 1 Causes 2 Presentation 3 Diagnosis 4 Treatment 5 Prognosis 6 References

[edit] Causes

PVL is caused by a lack of oxygen or blood flow to the periventricular area of the brain, which results in the death or loss of brain tissue. The periventricular area (the area around the spaces in the brain called ventricles) contains nerve fibers that carry messages within the brain.

[edit] Presentation

Although babies with PVL generally have no outward signs or symptoms of the disorder, they are at risk for motor disorders (especially of the lower limbs), delayed mental development, coordination problems, and vision and hearing impairments. Children with PVL have higher levels of nystagmus, strabismus, optic nerve hypoplasia and refractive error. PVL may be accompanied by a hemorrhage or bleeding in the periventricular-intraventricular area (the area around and inside the ventricles), and can lead to cerebral palsy.

[edit] Diagnosis

The disorder can be diagnosed by ultrasound, but magnetic resonance imaging of the head is diagnostically more accurate.

[edit] Treatment

The clinically available anticonvulsant topiramate, when administered post-insult in vivo, is considered to be protective against selective hypoxic–ischemic white matter injury and decreases the subsequent neuromotor deficits. Topiramate also attenuates AMPA–kainate receptor-mediated cell death and calcium influx, as well as kainate-evoked currents in developing oligodendrocytes.^[1]

Children with PVL should receive regular medical screenings to determine appropriate interventions.

[edit] Prognosis

The prognosis for individuals with PVL depends upon the severity of the brain damage. Some children exhibit fairly mild symptoms, while others have significant deficits and disabilities.

[edit] References

v • d • e Certain conditions originating in the perinatal period (P, 760-779) Maternal factors and complications Umbilical cord prolapse - Nuchal cord - Chorioamnionitis Length of gestation and fetal growth Small for gestational age - Large for gestational age - Premature birth - Postmature birth Birth trauma Cephalhematoma - Brachial plexus lesion (Erb's palsy, Klumpke paralysis) Respiratory Intrauterine hypoxia - Infant respiratory distress syndrome - Transient tachypnea of the newborn - Meconium aspiration syndrome - pleural disease (Pneumothorax, Pneumomediastinum) - Wilson-Mikity syndrome - Bronchopulmonary dysplasia Cardiovascular Pneumopericardium - Persistent fetal circulation Haemorrhagic and haematological/ hematologic disease Haemorrhagic disease of the newborn - Hemolytic disease of the newborn - Rh disease - Hydrops fetalis - Hyperbilirubinemia (Kernicterus, Neonatal jaundice) Digestive system Ileus - Necrotizing enterocolitis Integument and temperature regulation Erythema toxicum Other disorders Periventricular leukomalacia - Gray baby syndrome - muscle tone (Congenital hypertonia, Congenital hypotonia) - Congenital rubella syndrome