Periventricular leukomalacia, or PVL, is a type of brain damage that can affect the white matter of the brain. The white matter is essential for transporting impulses to the brain’s gray matter. When the white matter is damaged due to PVL, it can result in impairment of the function. The cells in the white matter will decay and die. This leaves an area of the brain empty and fluid will begin to build in this location. Experts estimate that a large percentage of children (between 60% and 100%) with periventricular leukomalacia will then develop cerebral palsy. The most common type of cerebral palsy to develop in these cases is spastic diplegia. In some cases quadriplegia cerebral palsy may develop, but it is rare.
What Are the Risk Factors?
This condition can occur any time before birth, but researchers have found that there are certain stages of development when the unborn is more vulnerable to periventricular leukomalacia. Research shows that the fetus may be at greater risk between weeks 26 and 34 of gestation. Children who are born prematurely are at a greater risk of periventricular leukomalacia as well. It is more common in infants born with a birth weight of less than 3.3 pounds and who were born before 32 weeks of gestation. The premature babies are also at a greater risk of death if they develop periventricular leukomalacia.
Doctors have discovered that there are a number of other risk factors that can increase the likelihood of a baby developing PVL. These include having twins, antepartum hemorrhage, inflammation of the umbilical cord, sepsis, lack of oxygen to the infant’s periventricular area, abnormal amounts of bacteria in the amniotic fluid, as well as issues with the placental blood vessel.
Looking for the Signs and Symptoms
PVL is very difficult to detect in infants who are less than six months old. One of the reasons for this is that many infants do not show any signs of impairment or damage. In addition PVL can mimic other medical conditions, and the doctors may not always realize that it is PVL. In some cases, it will take months, or even years, before they are able to receive a proper diagnosis. Still, there are some signs and symptoms that parents can watch for that will alert them to signs of trouble with their child’s development, and potential PVL.
Some of the things that parents should watch for in their children include problems with coordination, vision problems, issues with hearing, and cognitive impairment. As mentioned, these signs and symptoms may seem similar to other types of conditions. It is important to receive an examination and diagnosis from a medical professional.
In the event the doctors do believe the child is suffering from PVL, they will have the child go through a number of developmental assessment tests to help them pinpoint the diagnosis. One of the techniques they may use is a cranial ultrasound. They will not usually perform this test on the child until he or she is at least six months old. If they give the test earlier, it may not accurately detect the PVL. Once they make the diagnosis, they will come up with a treatment plan, which can vary based on the severity of the disorder. Typical treatments include a variety of therapy styles, which can include speech therapy and physical therapy. In the event that the child has vision issues due to the PVL, the doctor may recommend corrective vision treatment.
The prognosis for the children varies by the severity of the disorder. Some children may have severe disabilities that require treatment and care for life. Others may have only minor issues. Parents should talk with the doctors about providing the best type of treatment for their children.