Cross-sectional comparison of periventricular leukomalacia in preterm and term children

Neurology. 2010 Apr 27;74(17):1386-91. doi: 10.1212/WNL.0b013e3181dad62d.


Objective: To document and contrast the characteristics of preterm and term-born children with cerebral palsy attributed to underlying radiologic periventricular white matter injury (leukomalacia) (PVWMI/PVL).

Methods: A comprehensive cerebral palsy population-based registry (REPACQ) for a 4-year inclusive (1999-2002) birth cohort was systematically searched for all children with radiologic evidence for PVWMI/PVL. Clinical features, neurologic subtype, gross motor functional impairment, and comorbidities were compared in those children born preterm (<37 weeks) and those born at term (> or = 37 weeks).

Results: Of 242 children with cerebral palsy in the registry, 213 had available neuroimaging, in which 41 had PVWMI/PVL: 26 preterm born and 15 term born. Neurologic subtype differed significantly between preterm and term-born children with respect to the frequency of spastic hemiplegia (5/26 vs 8/15; p < 0.05) and spastic diplegia (9/26 vs 2/15; p < 0.05). The groups also differed significantly from a functional perspective (Gross Motor Function Classification System for Cerebral Palsy level I-II; 12/26 vs 12/15; p < 0.05). The comorbidity spectrum was similar between the 2 groups except for the occurrence of cortical blindness in the term-born children (3/15 vs 0/26; p < 0.05).

Conclusion: Differences between preterm and term-born children with cerebral palsy with periventricular white matter injury (leukomalacia) suggest that despite a common radiologic pattern, these are different clinicopathologic entities with perhaps a different gestational timing of acquired injury.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blindness, Cortical / diagnostic imaging
  • Blindness, Cortical / etiology
  • Blindness, Cortical / pathology
  • Brain / diagnostic imaging*
  • Brain / pathology
  • Cerebral Palsy / diagnostic imaging*
  • Cerebral Palsy / etiology
  • Cerebral Palsy / pathology
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Leukomalacia, Periventricular / complications
  • Leukomalacia, Periventricular / diagnostic imaging*
  • Leukomalacia, Periventricular / pathology
  • Male
  • Quebec
  • Radiography
  • Registries
  • Retrospective Studies
  • Severity of Illness Index