Periventricular leukomalacia (PVL), a white matter injury (WMI) affecting the premature infant's brain is commonly associated with ce- rebral palsy (CP). Among premature infants 〈 1,500 g, approximately 7,000 ...Periventricular leukomalacia (PVL), a white matter injury (WMI) affecting the premature infant's brain is commonly associated with ce- rebral palsy (CP). Among premature infants 〈 1,500 g, approximately 7,000 develop CP yearly and 20,000-30,000 exhibit major cognitive deficits yearly (Volpe, 2009). PVL results from hypoxia-ischemia (HI) with or without infection and is characterized by white matter necrotic lesions, hypomyelination, microglial activation, astrogliosis, and neuronal death. Risk factors for the development of PVL include: prematurity associated with immature cerebrovascular development, HI insults with lack of appropriate auto-regulation of cerebral blood flow, free radical production, energy deprivation, intrauterine infec- tion and chorioamnionitis. Affected infants show definitive signs of cerebral palsy such as spastic diplegia, seizures, developmental delay, visual and hearing impairment, scoliosis and incontinence by 6-9 months of age. PVL can also occur in term infants with certain con- genital cyanotic heart disease which will not be our focus here (Volpe, 2001).展开更多
基金supported by Lilling Family Neonatal Research Lab,Feinstein Institute for Medical Research
文摘Periventricular leukomalacia (PVL), a white matter injury (WMI) affecting the premature infant's brain is commonly associated with ce- rebral palsy (CP). Among premature infants 〈 1,500 g, approximately 7,000 develop CP yearly and 20,000-30,000 exhibit major cognitive deficits yearly (Volpe, 2009). PVL results from hypoxia-ischemia (HI) with or without infection and is characterized by white matter necrotic lesions, hypomyelination, microglial activation, astrogliosis, and neuronal death. Risk factors for the development of PVL include: prematurity associated with immature cerebrovascular development, HI insults with lack of appropriate auto-regulation of cerebral blood flow, free radical production, energy deprivation, intrauterine infec- tion and chorioamnionitis. Affected infants show definitive signs of cerebral palsy such as spastic diplegia, seizures, developmental delay, visual and hearing impairment, scoliosis and incontinence by 6-9 months of age. PVL can also occur in term infants with certain con- genital cyanotic heart disease which will not be our focus here (Volpe, 2001).