NEURO-DEVELOPMENTAL OUTCOME IN PREMATURE INFANTS WITH PERIVENTRICULAR WHITE MATTER INJURY
Dr Kessel Irena, Neonatology Department
Carmel Medical Center, Haifa
תוצאה נוירולוגי התפתחותי בפגים עם פגיעה בחומר הלבן הפריוונטריקולרי
ד"ר אירנה קסל, מרכז רפואי כרמל, חיפה, ישראל
Periventricular white matter injury affects the neuro-developmental outcome in preterm infants. It manifests by cognitive and motor delay, cerebral palsy, neuro-sensory impairment or behavioral deficits.
Periventricular white matter injury is a brain injury spectrum including focal cystic periventricular lesions, diffuse periventricular white matter injury, ventriculomegaly and reduction of white matter volume, enlarged subarachnoid space and immature gyral development. Cystic perivetricular leukomalacia may be accompanied by diffuse periventricular white matter injury or may be an isolated lesion. The highest risk for the periventricular white matter injury is between 23 and 32 weeks’ post-conception age, in infants of lower gestational age and birth weght 500-1000grams. Factors associated with the increased risk of white matter damage in preterm infants are divided to prenatal, perinatal and postnatal. The mechanisms of white matter injury are supposed to be vascular and inflammatory that take place in mentioned developmental window. Cystic perivetricular leukomalacia is diagnosed by brain sonography and diffuse periventricular white matter injury – by Magnetic Resonance Imaging. The type of the handicap depends on the variant and localization of white matter injury. Early diagnosis of white matter injury in premature infants is important for the targeted developmental care.