A history of our understanding of cerebral vascular development and pathogenesis of perinatal brain damage over the past 30 years

Semin Pediatr Neurol. 2009 Dec;16(4):226-36. doi: 10.1016/j.spen.2009.09.004.


This article reviews our studies focusing on cerebral vascular development, the pathogenesis of subependymal/intraventricular hemorrhage (SEH/IVH), periventricular leukomalacia (PVL), and pontosubicular neuron necrosis (PSN). Their pathogenesis consists of predisposing developmental and causal factors. SEH/IVH may be caused by reperfusion or overperfusion following ischemia in the subependymal germinal matrix with characteristic vasculature. The cause of PVL is multifactorial (ie, ischemia and inflammation), predisposed by the maturational status of the vasculature and oligodendroglia in the white matter. Focal PVL is ischemic necrosis, and diffuse PVL or white matter injury may include cytotoxic damage. PSN has an apoptotic character, and may be induced by ischemic and oxidative stress on specific immature neurons. Further studies on preventive and therapeutic measures are necessary in clinical, pathologic, and experimental fields. The monitoring and control methods of brain hemodynamics and cellular stability should be more developed to prevent brain damages.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Brain / growth & development
  • Brain / pathology
  • Brain Diseases / etiology*
  • Brain Diseases / history
  • Cerebral Arteries / growth & development*
  • Cerebral Arteries / pathology
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / history
  • Cerebral Veins / growth & development*
  • Cerebral Veins / pathology
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature, Diseases* / etiology
  • Infant, Premature, Diseases* / history
  • Infant, Premature, Diseases* / pathology
  • Leukomalacia, Periventricular / etiology
  • Leukomalacia, Periventricular / history