Neonatal periventricular haemorrhage and periventricular leucomalacia

Abstract

Apart from death, brain injury is the major adverse outcome of neonatal intensive care. A classification of neonatal cranial haemorrhages is shown in Table 1. In very low birth weight (VLBW) premature infants i.e. those < 1500 g, periventricular haemorrhage (PVH ) and periventricular leucomalacia (PVL) are of major clinical importance and will form the subject of this review. Our understanding of PVH and PVL has increased following the development of cranial ultrasound imaging in the late 1970s. Both conditions had previously been identified in post-mortem studies or following catastrophic clinical events; cystic changes corresponding to PVL were first described in 1867 by Virchow. Small haemorrhages not suspected clinically are now known to be very common. Over the last 15 years a considerable amount of research effort has been expended in describing the natural history of PVH and PVL, as well as evaluation of possible preventative strategies and assessment of the neurodevelopmental consequences.