Ultrasonographic Manifestations of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka
Periventricular Leukomalacia (PVL) is a White Matter
Injury (WMI) of preterm neonatal brain. Objectives of the study were
to assess the neuro-developmental outcome at one year of age and to
determine a good protocol of cranial ultrasonography to detect PVL.
Two hundred and sixty four preterm neonates were included in the
study. Series of cranial ultrasound scans were done by using a
dedicated neonatal head probe 4-10 MHz of Logic e portable
ultrasound scanner. Clinical history of seizures, abnormal head
growth (hydrocephalus or microcephaly) and developmental
milestones were assessed and neurological examinations were done
until one year of age. Among live neonates, 57% who had cystic PVL
(Grades 2 and 3) manifested as cerebral palsy. In conclusion cystic
PVL has permanent neurological disabilities like cerebral palsy.
Good protocol of real time cranial ultrasonography to detect PVL is
to perform scans at least once a week until one month and at term (40
weeks of gestation).
[1] M. Carol Rumack , R. Stephanie Wilson, R. William Charbonneau, et al,
Diagnostic ultrasound, 4th edition, vol 2, 2011, pp. 1596-1612.
[2] Erik Beek, and Floris Groenendaal, Neonatal brain ultrasound, The
Radiology Assistant, April 1 2006.
[3] Kenneth D. Williams, Imaging evaluation of neonatal hypoxic ischemic
encephalopathy, SCOTT & WHITE Health care.
[4] Y. Benjamin Huang, and Mauricio Castillo, Hypoxic ischaemic brain
injury, imaging findings from birth to adulthood, Radiographics, 2008,
vol 28(2), pp. 417-39. [5] A. James Barkovich, R. Kevin Moore, V. Blaise Jones, Gilbert Vezina,
L. Bernadette Kock, Charles Rayband, et al, Diagnostic imaging in
pediatric neuroradiology, 2007, First Edition. Chapter 1:1, pp. 132-139.
[6] Joseph J. Volpe, Neurology of the newborn, Fifth edition, 2008, pp. 247-
461, 517-588.
[7] A. Santina, and Zamnelli, Guidelines to assist in the diagnosis of severe
hypoxic ischaemic encephalopathy, Medscape, June 2012.
[8] A. Waidermar Cario, Nelson text book of pediatrics, 19th edition, 2011,
pp. 566-572, 2059-2065.
[9] S. K. Shinha, S. W. D. Souza, R. Rivlin, and M. A. Chiswick, Ischaemic
brain lesions diagnosed at birth in preterm infants, clinical events and
developmental outcome, Archives of disease in childhood, July 1996,
vol75(1).
[10] Ming Chi Lai, and San Nan Yang, Perinatal hypoxic ischaemic
encephalopathy, Journal of Biomedicine and Biotechnology, vol
2011(2011), 6 pages.
[11] Gradner and R. Marcia, Outcomes in children experiencing neurologic
insults in preterm neonates, redOrbit, Dec. 18th 2005, vol 31(6), pp. 448,
451-6.
[12] Terence Zach, Ted Rosenkratz, more, Pediatric periventricular
leukomalacia, Medscape, update June 18th 2012.
[13] Tom Lissauer, and Graham Clayden, Illustrated textbook of pediatrics,
4th edition, 2012, p.49-66.
[14] Christine, P. Chao, and G. Christopher, Neonatal hypoxic ischaemic
encephalopathy, Radiographics, 2013, vol 33(1).
[15] Jun Su, Li Wang, Research advances in neonatal hypoglycemic brain
injury, Translational Paediatrics, October 2012.
[16] L. W. Chang, J. Liu ,and W. B. Li, A Preliminary study on diagnosis and
grading of hypoxic ischaemic brain damage of preterm infants, Pub
Med, Zhongguo Dang Dai ZaZhi, Aug 2007, vol 9(4), pp. 293
[17] Pavithra Logitharajah, A. Mary, Rutherford,and Frances Cowan,
Hypoxic ischaemic encephalopathy in preterm infants, antecedent
factors, brain imaging and outcome, Pediatric RESEARCH, 2009, vol66,
pp. 222-229.
[18] T. Cloherty, A. Stark, and E. Eichenwaid, Manual of neonatal care, 6th
edition, 2012, Chapter 54.
[19] Rachel Sidwell, and Mike Thomson, Concise pediatrics, First edition,
2001, pp. 383-384.
[20] Omar Islam, Eugene C. Lin, more, Germinal matrix haemorrhage
imaging, Medscape, 2013.
[1] M. Carol Rumack , R. Stephanie Wilson, R. William Charbonneau, et al,
Diagnostic ultrasound, 4th edition, vol 2, 2011, pp. 1596-1612.
[2] Erik Beek, and Floris Groenendaal, Neonatal brain ultrasound, The
Radiology Assistant, April 1 2006.
[3] Kenneth D. Williams, Imaging evaluation of neonatal hypoxic ischemic
encephalopathy, SCOTT & WHITE Health care.
[4] Y. Benjamin Huang, and Mauricio Castillo, Hypoxic ischaemic brain
injury, imaging findings from birth to adulthood, Radiographics, 2008,
vol 28(2), pp. 417-39. [5] A. James Barkovich, R. Kevin Moore, V. Blaise Jones, Gilbert Vezina,
L. Bernadette Kock, Charles Rayband, et al, Diagnostic imaging in
pediatric neuroradiology, 2007, First Edition. Chapter 1:1, pp. 132-139.
[6] Joseph J. Volpe, Neurology of the newborn, Fifth edition, 2008, pp. 247-
461, 517-588.
[7] A. Santina, and Zamnelli, Guidelines to assist in the diagnosis of severe
hypoxic ischaemic encephalopathy, Medscape, June 2012.
[8] A. Waidermar Cario, Nelson text book of pediatrics, 19th edition, 2011,
pp. 566-572, 2059-2065.
[9] S. K. Shinha, S. W. D. Souza, R. Rivlin, and M. A. Chiswick, Ischaemic
brain lesions diagnosed at birth in preterm infants, clinical events and
developmental outcome, Archives of disease in childhood, July 1996,
vol75(1).
[10] Ming Chi Lai, and San Nan Yang, Perinatal hypoxic ischaemic
encephalopathy, Journal of Biomedicine and Biotechnology, vol
2011(2011), 6 pages.
[11] Gradner and R. Marcia, Outcomes in children experiencing neurologic
insults in preterm neonates, redOrbit, Dec. 18th 2005, vol 31(6), pp. 448,
451-6.
[12] Terence Zach, Ted Rosenkratz, more, Pediatric periventricular
leukomalacia, Medscape, update June 18th 2012.
[13] Tom Lissauer, and Graham Clayden, Illustrated textbook of pediatrics,
4th edition, 2012, p.49-66.
[14] Christine, P. Chao, and G. Christopher, Neonatal hypoxic ischaemic
encephalopathy, Radiographics, 2013, vol 33(1).
[15] Jun Su, Li Wang, Research advances in neonatal hypoglycemic brain
injury, Translational Paediatrics, October 2012.
[16] L. W. Chang, J. Liu ,and W. B. Li, A Preliminary study on diagnosis and
grading of hypoxic ischaemic brain damage of preterm infants, Pub
Med, Zhongguo Dang Dai ZaZhi, Aug 2007, vol 9(4), pp. 293
[17] Pavithra Logitharajah, A. Mary, Rutherford,and Frances Cowan,
Hypoxic ischaemic encephalopathy in preterm infants, antecedent
factors, brain imaging and outcome, Pediatric RESEARCH, 2009, vol66,
pp. 222-229.
[18] T. Cloherty, A. Stark, and E. Eichenwaid, Manual of neonatal care, 6th
edition, 2012, Chapter 54.
[19] Rachel Sidwell, and Mike Thomson, Concise pediatrics, First edition,
2001, pp. 383-384.
[20] Omar Islam, Eugene C. Lin, more, Germinal matrix haemorrhage
imaging, Medscape, 2013.
@article{"International Journal of Medical, Medicine and Health Sciences:68810", author = "P. P. Chandrasekera and P. B. Hewavithana and S. Rosario and M. H. M. N. Hearth and D. M. R. D. Mirihella", title = "Ultrasonographic Manifestations of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka", abstract = "Periventricular Leukomalacia (PVL) is a White Matter
Injury (WMI) of preterm neonatal brain. Objectives of the study were
to assess the neuro-developmental outcome at one year of age and to
determine a good protocol of cranial ultrasonography to detect PVL.
Two hundred and sixty four preterm neonates were included in the
study. Series of cranial ultrasound scans were done by using a
dedicated neonatal head probe 4-10 MHz of Logic e portable
ultrasound scanner. Clinical history of seizures, abnormal head
growth (hydrocephalus or microcephaly) and developmental
milestones were assessed and neurological examinations were done
until one year of age. Among live neonates, 57% who had cystic PVL
(Grades 2 and 3) manifested as cerebral palsy. In conclusion cystic
PVL has permanent neurological disabilities like cerebral palsy.
Good protocol of real time cranial ultrasonography to detect PVL is
to perform scans at least once a week until one month and at term (40
weeks of gestation).
", keywords = "Cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia (PVL), preterm neonates.", volume = "9", number = "1", pages = "39-4", }
