PERIVENTRICULAR LEUCOMALACIA - ULTRASOUND SCAN DIAGNOSIS

Periventricular leucomalacia (PVL) is the most common form of hypoxemi c brain damage in infants. In PVL, there is usually a preceding histor y of asphyxia or hypoxia. This results in hypoxic-ischaemic damage to the region of the brain around the lateral ventricles, a particularly vulnerable area as it is in a border zone between arterial supplies. P VL is usually first recognised as an echodense heterogenic flare in th e anterior and posterior periventricular areas on brain ultrasound sca n. This must clearly be differentiated from the typical halo seen in n ewborns. The formation of pseudocystic periventricular lesions is typi cally seen after 2 weeks. Thereafter, PVL is characterized by ventricu lar asymmetry with irregular walls or by cerebral atrophy. Age-specifi c neurological ultrasound findings are rarely seen in patients with PV L. As these individual developmental stages of PVL cannot always be fo und by ultrasound scan, the following criteria for diagnosis are recom mended: Increased intense and heterogenic echodense areas followed by a breaking up of these echodense areas in the anterior and posterior p eriventricular regions on brain ultrasound scan Multiple and thick-wal led, initially non-communicating periventricular pseudocysts Persistan t typical asymmetrical dilatation of ventricles with irregular and blu rred ventricular walls.