Diagnosis of periventricular leucomalacia (PVL) in premature babies

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Read about diagnosis of periventricular leucomalacia (PVL). HUS (head ultrasounds) are required to confirm diagnosis of PVL in a premature baby.

Key points

  • Periventricular leucomalacia (PVL) is a condition in which decreased blood flow to brain tissue causes it to soften up and eventually die, leaving behind cysts, or holes, filled with fluid.
  • Cysts may take several weeks to appear, so a head ultrasound (HUS) is performed regularly to confirm diagnosis.
Periventricular leucomalacia (PVL) in a premature baby is diagnosed with a head ultrasound (HUS), which is performed regularly to look for cysts, if brain tissue damage occurred before or during birth.

Periventricular leucomalacia (PVL) is a condition in which decreased blood flow to brain tissue causes it to soften up and eventually die, leaving behind cysts, or holes, filled with fluid. Over time, these cysts may fuse together and enlarge or collapse. The affected brain tissue and the nerve fibres that run through it help to control body movement, and their loss most often affects this ability.

Mild periventricular leucomalacia (PVL)Head ultrasound showing normal ventricles and head ultrasound showing mild periventricular leucomalacia
Periventricular leucomalacia (PVL) is a condition where there is decreased blood flow to brain tissue. In the mild PVL ultrasound, there is an increased density around the ventricles which is suggestive of injury. Another head ultrasound should be performed to see if there has been progression.

Although the brain tissue damage may have occurred before birth, during delivery, or in the immediate days following birth, the cysts may take several weeks to appear, delaying a definitive diagnosis. Head ultrasound (HUS) is performed regularly to confirm diagnosis. If cysts are detected, they may appear to resolve themselves over the course of a month or more, but the longer-term damage from PVL will likely not appear until months later. Generally speaking, damage from PVL affects motor control and may lead to a diagnosis of cerebral palsy.

Cystic periventricular leucomalacia (PVL)Head ultrasound showing periventricular leucomalacia and head ultrasound showing cystic periventricular leucomalacia
Sometimes there is a progression of from the early changes seen in mild PVL, and cystic PVL develops. Low blood supply causes brain tissue to soften up and eventually die, leaving behind cysts, or holes, filled with fluid. Over time, these cysts may fuse together and enlarge or collapse, affecting control of body movement.

More information

Last updated: October 31st 2009