Two Diagnoses of Periventricular Leukomalacia in Children

It is normal for children to get sick, so parents should pay special attention. If they find that their children are feeling a little uncomfortable, they should take them for examination in time to avoid serious illness, which will cost a lot of money and energy to treat. So, are you unfamiliar with periventricular leukomalacia in children? It doesn’t matter. Below, I will introduce to you two diagnoses of periventricular leukomalacia in children. I hope it will be helpful to you.

Periventricular leukomalacia in children is a late change of hypoxic-ischemic encephalopathy and the main cause of cerebral palsy (mainly spastic paraplegia or quadriplegia) in premature infants. PVL is a secondary leukoencephalopathy seen in premature infants and surviving children of postnatal asphyxia. Due to hypoxic-ischemic brain parenchyma damage, periventricular leukomalacia occurs, leading to bilateral spastic hemiplegia, quadriplegia, and mental retardation.

1. Clinical diagnosis

PVL can cause cerebral palsy (mainly spastic paraplegia and quadriplegia), mental retardation, convulsions, and various eye abnormalities such as nystagmus, strabismus, and decreased vision. Its clinical symptoms are closely related to CT and MRI changes. Its typical CT manifestations are: the body and triangular part of the lateral ventricle are enlarged and irregular in shape; the white matter around the triangular part and body is significantly reduced, and in severe cases, the white matter in the center of the semioval is also significantly reduced; the sulci and fissures are widened and deepened, and the subcortical gray matter directly approaches the ventricular wall, with almost no white matter components in between. MRI is more sensitive than CT, and its main manifestations are: high signal in periventricular white matter T2WI; enlargement of the body and triangular part of the lateral ventricle, with irregular shape; a significant decrease in white matter around the triangular part and body, and in severe cases, a significant decrease in white matter in the centrum semiovale; widening and deepening of cerebral sulci and fissures, and subcortical gray matter directly approaching the ventricular wall, with almost no white matter components in between.

2. Ultrasound diagnosis

In the early stage of leukomalacia, ultrasound can show enhanced echoes of the white matter around the ventricles, unclear boundaries, and no space-occupying effect. If one is not aware of this, it is easy to miss the diagnosis. Therefore, during cranial ultrasound examination, the cross-sections that can display each ventricle need to be observed to see whether the echoes of the white matter nearby are homogeneous and whether there is any echo enhancement. As time goes by, fluid cystic areas can be seen inside, which are easier to be found by ultrasound! Neonatal hypoxic-ischemic encephalopathy and craniocerebral injury are common causes.

Generally, such children are detected in the neonatal period and have a history of intracranial infection, intrauterine infection or birth trauma. During cranial ultrasound examination, attention should be paid to whether the white matter echo is homogeneous. The contrast between early lesions and surrounding normal tissues is not very obvious and can be easily missed!

The above are the two diagnostic contents of periventricular leukomalacia in children. You can choose one of them to check your child. Once a problem is found, you should receive treatment in time. For more content, you can follow the editor at any time. The editor will continue to contribute sincerely to everyone. Thank you for your continued support.