Periventricular leukomalacia is brain injury to white matter, where the white matter softens and dies around the lateral ventricles, leaving fluid-filled cysts. PVL can occur preterm and term babies. PVL results from trauma, hypoxia or ischemia.
PVL occurs as the result of a ‘domino effect’ of inflammatory responses that occur after an oxygen deprivation-related injury to the blood-brain barrier. There are often few or no signs of PVL in newborns, and the issue can be missed entirely without routine screening. Problems suckling or unusual stiffness can be a sign of periventricular leukomalacia. Preliminary diagnoses are based on head imaging results, with the most effective method being an MRI.
The best way to treat PVL is to prevent it in the first place – neuroprotective drugs can be used in pregnancies at risk for PVL, and all steps should be taken to prevent premature births as well as hypoxia, ischemia, trauma, and overventilation. In eligible cases, hypothermia treatment must be used for infants who have hypoxic ischemic encephalopathy (HIE) that leads to PVL.