Abstract
Cystic periventricular Leukomalacia (CPVL), a hypoxic-ischemic lesion of the neonatal brain, which can now be diagnosed in life thanks to ultrasound brain scanning, is considered to be one of the main causes of cerebral palsy (CP), especially in preterm infants. The purpose of our study was to verify this assumption in a population of 337 of gestational age ≥32 weeks. The frequency of CPVL proved to be 5.4% for lesions with a diameter of ≥3 mm or 9.3% including those of smaller diameter. The development of CPVL infants was favorable in 29% and adverse in 71% of cases. In the latter cases neuromotor sequelae (CP in 62.5% and motor retardation in 8.5%) were accompanied by various other neuropsychic deficits. Prognosis depends on the site and size of the cysts, being harsher for posterior lesions and those exceeding 1 cm in diameter.
Sommario
La leucomalacia periventricolare cistica (CPVL), lesione ipossico-ischemica del cervello neonatale diagnosticabile in vita grazie all'ecografia cerebrale, viene considerata una delle principali cause della paralisi cerebrale infantile (P.C.I.), in particolare nei nati pretermine. Scopo della nostra ricerca è verificare tale ipotesi con una popolazione di 337 soggetti con E.G.≤32 settimane. L'incidenza della CPVL da noi rilevata è del 5.4% o del 9.3% considerando rispettivamente le forme con diametro ≥3 mm od anche quelle microcistiche (diametro <3 mm). L'evoluzione dei soggetti affetti da CPVL è favorevole nel 29% dei casi e sfavorevole nel 71%, con lo sviluppo di una sequela neuromotoria (PCI nel 62.5% e ritardo motorio nell'8.5%) variamente associata ad altri deficit neuropsichici. La prognosi è legata alla sede e alle dimensioni della cisti ed è tanto più grave per lesioni localizzate in sede posteriore od estese (di diametro ≥1 cm).
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References
Amiel Tison C., Grenier A.:Neurological assessment during the first year of life. New York: Oxford University Press, 1986.
Amiel Tison C.:Neurological evaluation of the maturity of newborn infants. Arch. Dis. Child 43:89–93, 1968.
Banker B., Larroche J.C.:Periventricular leukomalacia of infancy. A form of neonatal anoxic encephalopathy. Arch. Neurol. 7:386–410, 1962.
Bayley N.:Bayley scales of infant development. New York: The Psychological Corporation, 1969.
Bozynski M.E.A., Nelson M.N., Matalon T.S.A. et al. Cavitary periventricular leukomalacia: incidence and short-term outcome in infants weighing ≤1200 grams at birth. Dev. Med. Child. Neurol. 27:572–577, 1985.
Daum C., Kurtzberg D., Ruff H. et al.:,Preterm development of visual and auditory orienting in very low birth weight infants. Ped. Res. 14abs21, 1980.
De Vries L., Dubowitz L.M.S.:Cystic leucomalacia in preterm infants: site of lesion in relation to prognosis, Lancet ii:1075–1076, 1985.
Fawer C.L., Diebold P., Calame A.:Periventricular leucomalacia and neurodevelopmental outcome in preterm infants Arch. Dis. Child 62:300–36, 1987.
Hagberg B.:Nosology and classification of cerebral palsy. Giorn. Neuropsich. Età Evol. suppl. 4:18–24, 1989.
Hill A., Nelson G.L., Clark H.B., Volpe J.J.:Hemorrhagic periventricular leucomalacia: diagnosis by real-time ultrasound correlation with autopsy findings. Pediatrics 69:282–283, 1983.
Levene M.I., Wigglesworth J.S., Dubowitz V.:Hemorrhagic periventricular leucomalacia in the neonate: a real-time ultrasound study. Pediatrics 71:794–797, 1983.
Levene M.I.:Neonatal Neurology. Edinburgh: Churchill Livingstone, 1987.
Monset-Couchard M., de Bethmann O., Radvanyi Bouvet MF., et al.,Neurodevelopmental outcome in cystic periventricular leukomalacia (CPVL) (30 cases). Neuropediatrics 19:124–131, 1988.
Ometto A., Fazzi E.:Ultrasound clinical correlations in the assessment of the newborn at risk for brain damage. It. J. Neurol. Sci. suppl. 5:79–83, 1986.
Ometto A.:Aspetti ecografici della leucomalacia. Atti X Congresso di Neurologia Neonatale. Modena: Centro Studi Umana, pp. 101–103, 1989.
Pape K.E., Wigglesworth J.S.:Risk factors in the development of intraventricular hemorrhage in the preterm newborn. Arch. Dis. Child. 57:410–417, 1982.
Scher M.S., Table Dobson V., Carpenter N.A., Guthrie R.D.:Visual and Neurological Outcome of Infants with Periventricular Leukomalacia. Dev. Med., Child. Neurol. 31:353–365, 1989.
Sinha S.K., Davies J.M., Sims D.G., Chiswick M.C.:Relation between periventricular haemorrhage and ischemic brain lesions diagnosed by ultrasound in very preterm infants. Lancet ii:1154–1155, 1985.
Stewart A.L., Reynolds E.O.R., Hope P.L. et al.:Probability of neurodevelopmental disorders estimated from ultrasound appearance of brains of very preterm infants. Dev. Med. Child. Neurol 29:3–11, 1987.
Terman L.M., Merill M.A.:Stanford Binet Intelligence Scale. Boston: Houghton Miafflin, 1960.
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Fazzi, E., Lanzi, G., Gerardo, A. et al. Correlation between clinical and ultrasound findings in preterm infants with cystic periventricular leukomalacia. Ital J Neuro Sci 12, 199–203 (1991). https://doi.org/10.1007/BF02337034
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DOI: https://doi.org/10.1007/BF02337034