LATE PERIVENTRICULAR LEUKOMALACIA IN A PR EMATURE-INFANT

Background. Periventricular leucomalacia in preterm neonates is usuall y due to abnormal cerebral blood flow before and/or during delivery. I t is diagnosed during the first month of life. This study describes a case of late-developing periventricular leucomalacia. Case report. A g irl was delivered by cesarean section at the 23rd week of gestation th at was complicated by placenta previa. She weighed 880 g and immediate ly required resuscitation, She did not develop respiratory distress sy ndrome. She was intubated and ventilated for the first two weeks of li fe and developed bronchopulmonary dysplasia requiring corticosteroid t reatment. Extubation was possible on day 43. The neonate had been give n antibiotics for the first 10 days of life and indomethacin on day 8 because of a patent ductus arteriosus. Repeated craniosonography showe d moderate bilateral intraventricular hemorrhage and occipital areas o f hyperechogenicity that disappeared at the end of the first month of life. Repeated electroencephalograms revealed no positive rolandic sha rp waves until the infant was 42 days old. Craniosonography on day 48 showed areas of heterogenous hyperechogenicity and NMR imaging showed bilateral frontoparietal leucomalacia with loss of white matter. The b aby died on day 71. Conclusions. Late periventricular leucomalacia is exceptional and usually seen after postnatal abnormalities in cerebral blood flow and/or prolonged hypoxemia. Both these risk factors were a bsent in this patient.