Periventricular leukomalacia (PVL) is a softening of white brain tissue near the ventricles. The ventricles are fluid-filled chambers in the brain. These are the spaces in the brain that contain the cerebrospinal fluid (CSF). The white matter is the inner part of the brain. It sends information between the nerve cells and the spinal cord, and from one part of the brain to another.
PVL occurs because brain tissue has been injured or has died. A lack of blood flow to the brain tissue before, during, or after birth causes PVL. It is rarely possible to tell when or why this happens. PVL is sometimes linked to bleeding inside the brain (intraventricular hemorrhage). PVL can occur in babies who are born early (preterm or premature).
With PVL, the area of damaged brain tissue can affect the nerve cells that control motor movements. As the baby grows, the damaged nerve cells cause the muscles to become tight or shaky (spastic), and hard to move. Babies with PVL have a higher risk for cerebral palsy. This is a disorder that causes problems with muscle control. A child with PVL may also have thinking or learning problems.
It is not clear why PVL occurs. This area of the brain is very vulnerable to injury, especially in preterm babies whose brain tissues are more fragile. PVL may happen when the brain gets too little blood or oxygen. But it is not clear when PVL occurs. It may occur before, during, or after birth. Most babies who develop PVL are preterm, especially those born before 30 weeks. Other things that may be linked with PVL include early bursting or rupture of membranes (amniotic sac) and infection in the uterus.
PVL can happen in any baby. But the risk is higher in babies who are born preterm. Smaller, younger preterm babies are at higher risk.
In some mild cases, the condition causes no symptoms. PVL may not be apparent until months after birth. Symptoms can occur a bit differently in each baby. The most common symptom of PVL is spastic diplegia. This is a form of cerebral palsy that causes tight, contracted muscles, especially in the legs.
The symptoms of PVL can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Your child may also have tests, such as:
There is no treatment to cure PVL. Babies at risk for PVL may need special care after discharge from the hospital. Follow-up may include physical therapy, occupational therapy, and speech therapy.
PVL may lead to problems with physical or mental development. The severity of these problems varies. In these cases, the baby still needs to be checked from time to time for signs of problems. In the most severe cases, PVL can cause cerebral palsy or other serious physical and mental delays. Only time can tell how severe a child’s disability will be.
If your child is diagnosed with PVL, he or she should be checked regularly by a developmental specialist. This can help detect problems early so you and your child can get help early.
Call the healthcare provider if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider:
Article Last Updated: April 23, 2019
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