MAGNETIC-RESONANCE-IMAGING OF PERIVENTRICULAR LEUKOMALACIA AND ITS CLINICAL CORRELATION IN CHILDREN

The prevalence of periventricular leukomalacia and its association wit h clinical neurological signs in school-age preterm children are unkno wn. We matched 42 eight-year-old children who were born before term wi th birth weights lower than 1,750 gm (mean, 1,410 gm; gestational age, 31 weeks) with 42 children who were born at term and of normal birth weight, to compare clinical neurological status and magnetic resonance imaging findings. Of the children born prematurely, 9.5% had cerebral palsy and 31% had minor neurological dysfunction whereas 9% of the ch ildren born at term had minor neurological dysfunction and none had ce rebral palsy, Deviations in tongue movements, heel walking, Fogs test results, and finger opposition, as well as behavioral disturbances, di fferentiated the preterm from the full-term group. The prevalence of p eriventricular leukomalacia among all children born prematurely was 32 %. It was observed in all children with cerebral palsy, in 25% with mi nor neurological dysfunction, and in 25% of the clinically healthy pre term children. None of the children born at term had evidence of periv entricular leukomalacia. Children with periventricular leukomalacia es pecially demonstrated poor performance on heel walking and Fogs test. Though commonly found in preterm children, periventricular leukomalaci a is not uniformly associated with abnormal neurological findings. A t horough neurological examination is a better predictor of later develo pmental problems than is magnetic resonance imaging.