Cerebral palsy (CP) is a diagnosis that every new Kentucky parent dreads. Caused by brain injury or malformation that occurs during brain development, it can occur before, during, or after birth. One of the four types of brain damage that can cause CP is periventricular leukomalacia, or PVL.

Definition of Periventricular Leukomalacia

CerebralPalsy.org describes PVL as a brain injury that consists of damage to the white matter brain tissues. The white matter is responsible for transporting nerve impulses between gray matter cells. When white matter is damaged, the injured cells die and decay, leaving spaces in the brain that fill with fluid. This is called leukomalacia.

The periventricular white matter transports impulses that control motor function; damage in this region causes spasticity and intellectual impairment. Myelin sheaths coat and protect the neural pathways; if they are damaged, transmission of nerve impulses slows.

Risk Factors for PVL

Intrauterine infections seem to be a primary causative factor in PVL. Toxins from an infection pass through the amniotic fluid and can selectively damage parts of the baby’s brain. These toxins can also cause membranes to rupture prematurely, as well as premature birth.

A number of conditions brought on by premature birth (before 32 weeks of gestation), in which the baby is mechanically ventilated, can cause PVL. These include low blood pressure, a low concentration of oxygen in the blood, acidosis (too much acid in body tissues), and hypocarbia (too little carbon dioxide in the blood).

The following are additional risk factors for PVL:

  • A placental blood vessel condition called placental vascular anastomoses
  • Twin gestation
  • Vaginal bleeding during pregnancy (antepartum hemorrhage)
  • Chorioamnionitis, the inflammation of fetal membranes caused by a bacterial infection
  • Funisitis, or inflammation of the umbilical cord connective tissue
  • Sepsis, a serious condition in which bacteria invade the bloodstream
  • Maternal cocaine use

Symptoms of Periventricular Leukomalacia

PVL is not easy to detect in newborns. It can be mistaken for other conditions, and there is much variation between cases. Symptoms of PVL include:

  • Intellectual impairment
  • Developmental delay
  • Vision disorders
  • Hearing problems
  • Coordination difficulties

PVL can be identified using cranial ultrasounds, magnetic resonance imaging (MRI), and CT scans. Because PVL may not be detectable until the infant is 4 to 8 weeks old, infants at risk are usually tested about 30 days after birth.

PVL Prevention

Some experts believe that extensive tests run at five to seven weeks of gestation may be able to ascertain the presence of infection, thereby enabling medical staff to treat the infection and conceivably prevent PVL.

Has Your Family Been Impacted By A Birth Injury?

If your family has been impacted by a birth injury you need to speak with an experienced birth injury attorney as soon as possible. Contact us online or call our office directly at 888.450.4456 to schedule a free consultation.

Matthew L. White
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Founder & Partner of Louisville Personal Injury Law Firm Gray & White Law

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