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Leukomalacia

Periventricular leukomalacia (PVL) is characterized by the death of the white matter of the brain due to softening of the brain tissue. It can affect fetuses or newborns; premature babies are at the greatest risk of the disorder. PVL is caused by a lack of oxygen or blood flow to the periventricular area of the brain, which results in the death or loss of brain tissue. The periventricular area (the area around the spaces in the brain called ventricles) contains nerve fibers that carry messages from the brain to the body's muscles. more...

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Although babies with PVL generally have no outward signs or symptoms of the disorder, they are at risk for motor disorders, delayed mental development, coordination problems, and vision and hearing impairments. PVL may be accompanied by a hemorrhage or bleeding in the periventricular-intraventricular area (the area around and inside the ventricles), and can lead to cerebral palsy. The disorder is diagnosed by ultrasound of the head.

Treatment

There is no specific treatment for PVL. Treatment is symptomatic and supportive. Children with PVL should receive regular medical screenings to determine appropriate interventions.

Prognosis

The prognosis for individuals with PVL depends upon the severity of the brain damage. Some children exhibit fairly mild symptoms, while others have significant deficits and disabilities.

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Betamethasone May Cut Periventricular Leukomalacia
From OB/GYN News, 1/15/00 by Winnie Anne Imperio

Prenatal exposure to betamethasone, but not dexamethasone, significantly reduced the risk of cystic periventricular leukomalacia, a major cause of cerebral palsy, reported Dr. Olivier Baud of Antoine Beclere University Hospital in Clamart, France, and his associates.

Little has been known about the prophylactic effects of glucocorticoids against periventricular leukomalacia (N. Engl. J. Med. 341[16]:1190-96, 1999).

In a retrospective study, the rate of periventricular leukomalacia was 4.4% among 361 infants whose mothers had received betamethasone and 11.0% among 164 infants whose mothers had received dexamethasone.

The women received steroids because they were considered to be at risk for preterm delivery

The rate was 8.4% among 357 infants whose mothers received neither glucocorticoid.

After adjustment for covariates such as gestational age, delivery mode, and the presence of chorioamnionitis, infants whose mothers had received betamethasone had a 0.5 odds ratio of developing periventricular leukomalacia, compared with infants whose mothers did not receive glucocorticoids. Infants whose mothers had received dexamethasone had a 1.5 odds ratio.

COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group

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