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September 1972

Pathogenesis and Evolution of Periventricular Leukomalacia in Infancy

Author Affiliations

From the Charles S. Kubik Laboratory for Neuropathology of the James Homer Wright Pathology Laboratories, Massachusetts General Hospital, and the departments of neurology-neuropathology and pathology, Harvard Medical School, Boston. Doctor DeReuck was appointed as the Edgar Rickard Fellow by the Belgian American Educational Foundation, Inc., while on leave from the Neurological Department of the University of Ghent, Belgium.

Arch Neurol. 1972;27(3):229-236. doi:10.1001/archneur.1972.00490150037007

A survey of postmortem material related to cerebral injury at birth disclosed 13 cases of periventricular leukomalacia. Six patients survived for three months or longer; one reached adulthood. Our observations suggest that the lesions are infarcts located in the periventricular arterial end zones, between the ventriculopetal and ventriculofugal branches of deep penetrating arteries. They apparently are due to episodes of impaired circulatory perfusion during the first weeks of life. In children who survive the neonatal period, these infarcts appear as cavitations or as bands of gliosis in the periventricular regions, with extreme thinning of the white matter and secondary enlargement of the lateral ventricles. Whereas the clinical manifestations in the neonatal period are not distinctive, severe mental retardation and extensive neurological deficits appear in children who survive after the first few months of life.