West syndrome with periventricular leukomalacia: A morphometric MRI study

A morphometric magnetic resonance imaging study was performed, and the resu lts were compared among three groups (group 1, periventricular leukomalacia patients with West syndrome; group 2, periventricular leukomalacia patient s without West syndrome; and group 3, control patients) to clarify the char acteristics and cause of West syndrome. This study included 21 infants (11 males and 10 females, 7 months to 2 years 8 months old) born at 24-32 weeks of gestation and weighing 625-1,908 gm, The Evans ratio, ratio of the post erior horns, Cella media index, width of the third ventricle, and the areas of the midbrain, pens, and medulla oblongata were measured and compared am ong the three groups, There were no differences of gestation or birth weigh t among the three groups. The Evans ratio, ratio of the posterior horns, Ce lla media index, and width of the third ventricle were larger in group 1 th an in groups 2 and 3. The ratio of the posterior horns and Cella media inde x were larger in group 2 than in group 3, although the width of the third v entricle was not. Myelination was delayed in all patients in group 1 and in two patients in group 2, In group 1 the areas of the midbrain and pens wer e smaller than in groups 2 and 3 and the medulla oblongata was smaller than in group 3, although there were no differences in midbrain, pens, and medu lla oblongata between groups 2 and 3, Although the infants with periventric ular leukomalacia and West syndrome frequently demonstrated marked ventricu lar dilatation and delayed myelination, the atrophy of midbrain and pens wa s the most characteristic, and the damage may cause West syndrome. (C) 1998 by Elsevier Science Inc. All rights reserved.