PERIVENTRICULAR LEUKOMALACIA AND BRAIN PR OTECTION - 2 - DIAGNOSTIC, SEQUELAE AND NEUROPROTECTION

The term 'periventricular leukomalacia' (PVL) usually covers necrotic and/or gliotic lesions from perinatal origin occurring in the perivent ricular ring of telencephalic white matter. Carrying motor and neurops ychological consequences PLVs could be the most severe danger for very premature brains. Positive rolandic sharp waves recorded on EEG and p recocious abnormally echogenous periventricular images on ultrasound s uggest prospective periventricular cysts. Cystic periventricular cavit ations certify the diagnosis of PVL. More subtle lesions of PVL do nor reach the cystic grade and their diagnosis is confirmed by MRI. Treat ment of infections is already available and potentially a tool for pre vention. When the overwhelming glutamatergic signal has been triggered , neuroprotective agents turning off the excitotoxic cascade, includin g calcium blockers, growth factors and others, are promising therapeut ic tools. (C) 1998, Elsevier, Paris.