Brain injury in the premature infant. Neuropathology, clinical aspects, pathogenesis, and prevention

Clin Perinatol. 1997 Sep;24(3):567-87.


There are two principal lesions that underlie brain injury and the neurologic manifestations in the premature infant: periventricular hemorrhagic infarction and periventricular leukomalacia. Both of these lesions may be potentially preventable: periventricular hemorrhagic infarction by preventing germinal matrix-IVH, and periventricular leukomalacia by detecting impaired cerebrovascular regulation with near-infrared spectroscopy, preventing the impaired cerebral blood flow and interrupting the cascade to oligodendroglial cell death, perhaps by such agents as free-radical scavengers. Prenatal magnesium sulfate also may be valuable. The greatest progress toward prevention has been made regarding periventricular hemorrhagic infarction, but the advent of new technologies, especially near-infrared spectroscopy, and of new insights into the cellular basis for oligodendroglial vulnerability provide hope for prevention of periventricular leukomalacia.

Publication types

  • Review

MeSH terms

  • Brain Diseases / etiology*
  • Brain Diseases / pathology
  • Brain Diseases / prevention & control
  • Cell Death
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / pathology
  • Cerebral Hemorrhage / prevention & control
  • Cerebral Infarction / complications
  • Cerebral Infarction / pathology
  • Cerebral Infarction / prevention & control
  • Cerebrovascular Circulation
  • Free Radical Scavengers / therapeutic use
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / etiology*
  • Infant, Premature, Diseases / pathology
  • Infant, Premature, Diseases / prevention & control
  • Leukomalacia, Periventricular / complications
  • Leukomalacia, Periventricular / pathology
  • Leukomalacia, Periventricular / prevention & control
  • Magnesium Sulfate / therapeutic use
  • Oligodendroglia / pathology
  • Spectroscopy, Near-Infrared
  • Tocolytic Agents / therapeutic use


  • Free Radical Scavengers
  • Tocolytic Agents
  • Magnesium Sulfate