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The whole spectrum of cystic periventricular leukomalacia of the preterm infant: results from a large consecutive case series

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Abstract

Purpose

The purpose of this study is to describe features of cystic periventricular leukomalacia (PVL) in a large consecutive cohort study including long-term neurodevelopmental follow-up.

Methods

We performed a retrospective single-centre cohort study including all preterm infants ≤35 weeks of gestational age with PVL diagnosed by ultrasound scans (US) from a tertiary care university hospital between 1988 and 2012.

Results

The majority of 160 consecutively diagnosed cases had a gestational age between 28 and 32 weeks (60.6 %), and male sex was predominant (60.6 %). The most common associated clinical findings included respiratory distress syndrome, preterm premature rupture of the membranes, and chorioamnionitis (57.5, 49.4, and 39.4 %, respectively). Infants presented with apnoeas in 66.3 and neonatal seizures in 23.1 %. Any kind of respiratory support was present in 75.0 %. Associated low-grade intraventricular haemorrhage was evident in 33.1, high-grade haemorrhage in 9.4 %. Cysts were located on both hemispheres in 75 % and PVL grades 3 and 4 were predominant (75.6 %). Neurodevelopmental follow-up of 146 cases at a median age of 72 months revealed normal development in 11.0, mental retardation in 50.0, and cerebral palsy in 83.6 %. Visual impairment was diagnosed in 21.9 % and hearing impairment in one case. A quarter of cases (27.4 %) developed seizure disorders. Outcome data were significantly better in unilateral compared to bilateral PVL.

Conclusions

Long-term neurodevelopmental outcome of bilateral PVL always was adverse and different from unilateral PVL. The latter might be negatively influenced by associated intra- and periventricular haemorrhages.

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Conflict of interest

The authors declare to have no conflict of interest.

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Authors and Affiliations

  1. Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    Bernhard Resch, Elisabeth Resch & Nora Hofer

  2. Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    Bernhard Resch, Ute Maurer-Fellbaum, Elisabeth Pichler-Stachl & Berndt Urlesberger

  3. Outpatient Department of Developmental Follow-Up, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    Ute Maurer-Fellbaum & Elisabeth Pichler-Stachl

  4. Division of Paediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria

    Michael Riccabona

Authors
  1. Bernhard Resch
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  2. Elisabeth Resch
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  3. Ute Maurer-Fellbaum
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  4. Elisabeth Pichler-Stachl
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  6. Nora Hofer
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  7. Berndt Urlesberger
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Correspondence to Bernhard Resch.

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Resch, B., Resch, E., Maurer-Fellbaum, U. et al. The whole spectrum of cystic periventricular leukomalacia of the preterm infant: results from a large consecutive case series. Childs Nerv Syst 31, 1527–1532 (2015). https://doi.org/10.1007/s00381-015-2786-3

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  • DOI: https://doi.org/10.1007/s00381-015-2786-3

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