Periventricular leukomalacia


Image 1

Clinical History: 
A 3 year-old girl, product of in vitro fertilization (with a normal twin), delivered by c-section at 30 weeks. She is mildly developmentally delayed, with spastic diplegic/triplegic cerebral palsy.

Periventricular leukomalacia

MR Technique: 
4.5 mm axial FSE (21 echoes) FLAIR and (17 echoes) T2-weighted images are presented, acquired at 1.5 T on a Siemens Avanto MR system. Sequence parameters were TR/TE/TI = 9000/121/2500 and TR/ TE = 5570/105, respectively. Scan times were 3:00 and 2:42 min:sec.

Imaging Findings:
There is a paucity of normal periventricular white matter, greatest near the posterior aspect of the lateral ventricles. Gliosis is also seen in these regions, with abnormal hyperintensity (and is best seen on FLAIR). The posterior body and the splenium of the corpus callosum are small (images not shown). Periventricular leukomalacia, also known as white matter injury of prematurity, is a brain injury that occurs prior to 33 weeks of gestation. There is loss of normal periventricular white matter, with associated gliosis and thinning of the corpus callosum. If the loss of white matter is predominantly posteriorly, there may be colpocephaly long term (disproportionate enlargement of the more posterior portions of the lateral ventricles, atria and occipital horns). Patients with periventricular leukomalacia commonly fall within the broad category clinically of cerebral palsy.