PERIVENTRICULAR LEUKOMALACIA OF THE PRETERM INFANT AND NEURODEVELOPMENTAL OUTCOME AT 18 MONTHS

Abstract

Periventricular leukomalacia(PVL) can be accurately identified in the neonatal period by means of ultrasonography and the use of high-frequency transducer. In order to establish its pronostic value, a prospective neurological and developmental assessment(Griffith's development quotient [DQ]) at 18 months corrected for prematurity was per formed on 82 infants of 34 weeks'gestation or less, alloca ted in 4 groups : 41 with normal scans(group I), 13 with isolated haemorrhage(group II), 4 with post-haemorrhagic ventricular dilatation(group III) and 24 with PVL associated or not with haemorrhage or dilatation(group IV). The outcome was good and similar in group I,II and III.By contrast, the outcome of group IV was worse and seemed to depend on the extent and site of PVL: 1)Frontal areas(n=13): all babies developed normally. 2)Frontal-parietal areas (n=6): 3 had major handicap. 3)Frontal-parietal-Occipital areas(n=5): all had major handicap. Our study indicate that major sequelae are more closely related to the extent and localisation of PVL than to haemorrhage or ventricular dilatation as previously reported.