Non-economic damages can be difficult to get an exact dollar amount because these losses do not have a clear value. We studied MRI findings of a periventricular high-signal intensity pattern in 151 adults older than 50 years. PVL is anticipated to become more prevalent due to advances in perinatal care and consequent improved survivorship. Uncommon extensive juxtacortical necrosis of the brain. 1991;33(6):478-93. doi: 10.1007/BF00588038. All treatments administered are in response to secondary pathologies that develop as a consequence of the PVL. FOIA In an Israel-based study of infants born between 1995 and 2002, seizures occurred in 102 of 541, or 18.7%, of PVL patients. Periventricular leukomalacia (PVL) is a softening of white brain tissue near the ventricles. The differentiating features of true glaucoma in adulthood versus pseudoglaucomatous cupping from PVL are described in Table 2. Pediatrics. 1974 Apr 30;27(4):277-88. doi: 10.1007/BF00690693. Periventricular means around or near ventricles, the spaces in the brain that make Cerebral Spinal Fluid (CSF). 1983;71(5):794-797. 'MacMoody'. Have multi-level lower extremity spasticity, meaning spasticity or high muscle tone in multiple muscle groups in their lower extremities that's affecting their gait. Premature children have a higher risk of PVL. . Children whore born prematurely are at higher risk of PVL. Pathologic changes consisted of infarction and demyelination of periventricular white matter, with associated necrotic foci in the basal ganglia in some cases. The more premature the baby, the greater the risk of PVL. The outlook for individuals with PVL depends upon the severity of the brain damage. The periventricular area is the area around the ventricles (fluid-filled cavities/spaces in the brain) where nerve . (https://www.ninds.nih.gov/Disorders/All-Disorders/Periventricular-Leukomalacia-Information-Page). It sends information between the nerve cells and the spinal cord, and . Some children exhibit relatively minor deficits, while others have significant deficits and disabilities. National Library of Medicine The associated emotional and financial burden associated with misdiagnosis with glaucoma can significantly impact quality of life of patients. Accessibility To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2023 American Medical Association. Children and adults may be quadriplegic, exhibiting a loss of function or paralysis of all four limbs. Jacques L. De Reuck, MD; Henri M. Vander Eecken, MD. Because white matter injury in the periventricular region can result in a variety of deficits, neurologists must closely monitor infants diagnosed with PVL in order to determine the severity and extent of their conditions. Typically, some abnormal neurological signs (such as those previously mentioned) are visible by the third trimester of pregnancy (28 to 40 weeks after conception), and definitive signs of cerebral palsy are visible by six to nine months of age.[18]. Periventricular leukomalacia (PVL) is a kind of brain damage that occurs to the inner part of your brain (white matter). Focal PLV consists of localized cell necrosis in periventricular white matter. Periventricular leukomalacia. Cytokine immunoreactivity in cortical and subcortical neurons in periventricular leukomalacia: are cytokines implicated in neuronal dysfunction in cerebral palsy? The percentage of individuals with PVL who develop cerebral . Incidence of PVL in premature neonates is estimated to range from 8% to 22% 1,2; the cystic form of PVL, which is associated with more severe defects, has an estimated incidence of 5%3. Jalali, Ali, et al. Periventricular leukomalacia is a form of brain injury and one of the important causes of cerebral palsy and cognitive issues in premature infants.1 Various studies are being conducted to assess the use of better diagnostic methods and treatment modalities for Periventricular leukomalacia. The extent of cell necrosis could be limited and develop into glial scars. Many infants with PVL eventually develop cerebral palsy. Jacobson LK, Dutton GN. [7] Additionally, infants with PVL may not be able to assume the same positions for sleeping, playing, and feeding as premature or full-term children of the same age. Access for 1 day (from the computer you are currently using) is US$ 39.00. In most hospitals, premature infants are examined with ultrasound soon after birth to check for brain damage. These symptoms include problems controlling movement, developmental delays, learning disabilities and seizures. It is often impossible to identify PVL based on the patient's physical or behavioral characteristics. Treatments for PVL focus on improving your childs quality of life. However, diffuse lesions without necrosis are not PVL. PVL may happen before, during or after birth. grade 2: the echogenicity has resolved into small periventricular cysts. 2003 Gordon Dutton. Progressive multifocal leukoencephalopathy with paramyxovirus-like structures, Hirano bodies and neurogibrillary tangles. Neuroradiology. Periventricular leukomalacia (PVL) is a brain injury disorder characterized by the death of the white matter of the brain due to softening of the brain tissue. Periventricular leukomalacia. decreased oxygen/blood flow to the periventricular region of the brain, and 2.) PVL leads to problems with motor movements and can increase the risk of cerebral palsy. Submit only on articles published within 6 months of issue date. La CP (parlisis cerebral) es un trastorno neurolgico a menudo causado por eventos en los primeros aos de vida que afectan la funcin neurolgica en varios niveles. Abstract. The white matter is the inner part of the brain. The severity and extent of the ophthalmic ocular manifestations of PVL are typically dependent on the degree of cerebral injury. Periventricular leukomalacia (PVL) develops when the white matter of the brain is damaged during childbirth. The preliminary diagnosis of PVL is often made using imaging technologies. The https:// ensures that you are connecting to the Periventricular leukomalacia (PVL), the main substrate for cerebral palsy, is characterized by diffuse injury of deep cerebral white matter, accompanied in its most severe form by focal necrosis. La leucomalacia periventricular (PVL, por sus siglas en ingls) es la muerte o el dao y el reblandecimiento de la sustancia blanca, parte interna del cerebro que transmite informacin entre las clulas nerviosas y la mdula espinal, as como de una parte del cerebro a otra. Chapter: 760-779. 2021;77(2):147-153. doi:10.1016/j.mjafi.2020.05.013, 7. 8600 Rockville Pike White matter disease is a medical condition in adults caused by the deterioration of white matter in the brain over time. [citation needed], Please help improve this article, possibly by. No, I did not find the content I was looking for, Yes, I did find the content I was looking for, Please rate how easy it was to navigate the NINDS website. Stroke. It is crucial for doctors to observe and maintain organ function: visceral organ failure can potentially occur in untreated patients. Although there is no current cure for PVL, several treatment options can minimize complications. These ventricles are fluid-filled; they contain CSF or cerebrospinal fluid. Findings are usually consistent with white matter loss and thinning of periventricular region. Ganesh S, Khurana R, Wallang B, Sharma S. Ophthalmic Manifestations in Children with Periventricular Leukomalacia. The Academy uses cookies to analyze performance and provide relevant personalized content to users of our website. It sends information between the nerve cells and the spinal cord, and from one part of the brain to another. All Adult Pediatric Patient Graphics. What Is Periventricular Leukomalacia? 2023 American Medical Association. Haynes RL, Folkerth RD, Keefe RJ, Sung I, Swzeda LI, Rosenberg PA, Volpe JJ, Kinney HC. The topographical anatomy of the PVL injury typically correlates with the the type and severity of the visual field defect. What is periventricular leukomalacia in adults? Your email address, e.g. The typical distribution of PVL has been correlated . Radiological Diagnosis of Periventricular and Subcortical Leukomalacia. Indian J Ophthalmol. Neuro-ophthalmic Manifestations in Adults after Childhood Periventricular Leukomalacia. Date 06/2024. Careers. Susceptibility can be attributed, at least in part, to a relative deficiency of superoxide dismutases in the preterm white matter, including premyelinating oligodendrocytes. Increased signal intensity in the periventricular region on T2-weighted MRI and findings of decreased white matter in the periventricular region are diagnostic of PVL (Figure 1). Huo R, Burden SK, Hoyt CS, Good WV. PVL with ocular involvement typically includes characteristic pseudoglaucomatous nerve cupping. PVL may occur before, during or after birth. Levene MI, Wigglesworth JS, Dubowitz V. Hemorrhagic periventricular leukomalacia in the neonate: a real-time ultrasound study. The processes affecting neurons also cause damage to glial cells, leaving nearby neurons with little or no support system. Definition. Acute fatal posthypoxic leukoencephalopathy following benzodiazepine overdose: a case report and review of the literature. PVL and other in utero or neonatal insults, however, can produce trans-synaptic degeneration across the lateral geniculate body and thus produce optic atrophy mimiciking pre-geniculate lesions in adults. eCollection 2021. 2014;62(10):992-995. doi:10.4103/0301-4738.145990, 13. This tissue is located near the fluid-filled ventricles in the brain. 2023 American Medical Association. Periventricular leukomalacia (PVL) is a type of brain injury most common in very premature babies. The extent of PVL may be further assessed using fMRI with various visual stimuli. Periventricular leukomalacia is caused by a lack of oxygen or blood flow to the periventricular area of the brain, which results in the death or loss of brain tissue. All Rights Reserved. Periventricular leukomalacia: Relationship between lateral ventricular volume on brain MR images and severity of cognitive and motor impairment. PVL also increases the risk of cerebral palsy, learning disabilities and other problems with development. Approximately 60-100% of children with periventricular leukomalacia are diagnosed with Cerebral Palsy. PVL is injury to the white matter around the fluid-filled ventricles of the brain. However, term infants with congenital cardiac or pulmonary disease are slightly more prone to PVL. We do not endorse non-Cleveland Clinic products or services. [1, 2] In relatively recent years, this terminology has been somewhat controversial, as PVL reflects a categorization by neuropathologic findings.There have been suggestions that "white matter injury" be used instead, of which PVL would be a subcategory. Surgical intervention is typically not warranted in PVL. J Neuropathol Exp Neurol. The .gov means its official. These disorders are . The cause of periventricular leukomalacia isnt clear. Periventricular Leukomalacia refers to the damage and cell death in the tissues of the white matter. Unfortunately, premature infants are also at the . Preventing or delaying premature birth is considered the most important step in decreasing the risk of PVL. Liu, Volpe, and Galettas Neuro-Ophthalmology (Third Edition). 2018;85(7):572-572. doi:10.1007/s12098-018-2643-y. [5] No agencies or regulatory bodies have established protocols or guidelines for screening of at-risk populations, so each hospital or doctor generally makes decisions regarding which patients should be screened with a more sensitive MRI instead of the basic head ultrasound. However, since healthy newborns (especially premature infants) can perform very few specific motor tasks, early deficits are very difficult to identify. BMC Neurol. Would you like email updates of new search results? Additionally, motor deficits and increased muscle tone are often treated with individualized physical and occupational therapy treatments. (Exception: original author replies can include all original authors of the article). Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment. Schellinger D, Grant EG, Richardson JD. Zaghloul. Periventricular leukomalacia -MRI. Periventricular leukomalacia (PVL) is a type of brain injury that affects premature infants. By continuing to use our site, or clicking "Continue," you are agreeing to our. For assistance, please contact: The following code (s) above G93.89 contain annotation back-references that may be applicable to G93.89 : G00-G99. [8] Additionally, children with PVL often exhibit nystagmus, strabismus, and refractive error. government site. Esotropia and nystagmus may also be present11,13. Acta Paediatr. This site is protected by reCAPTCHA and the GooglePrivacy Policyand Terms of Serviceapply. Note that perinatal postgeniculate injury such as PVL may produce optic atrophy via trans-synaptic degeneration. The clinical model of periventricular leukomalacia as a distinctive form of cerebral white matter injury is important for understanding cognitive and social functioning in typical and atypical development because (i) compared with lesions acquired later in life, the model deals with brain damage of early origin (early-to-middle third trimester . Periventricular Leukomalacia (PVL) is a condition characterized by injury to white matter adjacent to the ventricles of the brain. PVL may occur when not enough blood or oxygen gets to your childs brain. An emphasis on prenatal health and regular medical examinations of the mother can also notably decrease the risk of PVL. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745826/). Pathophysiology of periventricular leukomalacia: What we learned from animal models. [5], Although no treatments have been approved for use in human PVL patients, a significant amount of research is occurring in developing treatments for protection of the nervous system. 2003 Mar;105(3):209-16. doi: 10.1007/s00401-002-0633-6. Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis (more often coagulation) of white matter near the lateral ventricles. . PVL involving the optic radiations is one of the most common causes of visual impairment in patients with a history of prematurity4. Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis . . Online ISSN:1526-632X, The most widely read and highly cited peer-reviewed neurology journal. Early water breaking or bursting of your membranes (amniotic sac). Avoiding premature birth allows the fetus to develop further, strengthening the systems affected during the development of PVL. Ringelstein EB, Mauckner A, Schneider R, Sturm W, Doering W, Wolf S, Maurin N, Willmes K, Schlenker M, Brckmann H, et al. There is no specific treatment for PVL. Carbon monoxide intoxication was excluded. [17] More white matter damage leads to more severe cerebral palsy; different subtypes are identified and diagnosed by a neurologist. Learn about clinical trials currently looking for people with PVL at, Where can I find more information about p. Did you find the content you were looking for? Leech R, Alford E. Morphologic variations in periventricular leukomalacia. Haynes RL, Baud O, Li J, Kinney HC, Volpe JJ, et al. Although PVL is well known among pediatric ophthalmologists, adults may present with neuro-ophthalmic findings of childhood PVL. Those patients with severe white matter injury typically exhibit more extensive signs of brain damage. But you can help improve your childs quality of life by seeking treatment as soon as symptoms appear. It sends information between the nerve cells and the spinal cord, and from one part of the brain to another. Unauthorized use of these marks is strictly prohibited. Correlation of ultrasound, clinical, and nuclear magnetic resonance functions", "Epilepsy in children with cerebral palsy", https://en.wikipedia.org/w/index.php?title=Periventricular_leukomalacia&oldid=1136409434, Drawing of the lateral and third ventricles of the brain. Microglia, which express toll-like receptors to bacterial products such as lipopolysaccharide, are increased in PVL white matter and may contribute to the injury. The condition involves the death of small areas of brain tissue around fluid-filled areas called ventricles. The prognosis of patients with PVL is dependent on the severity and extent of white matter damage. White matter exists around the spaces in your brain that contain fluid (ventricles). Table 2: Comparison of characteristic clinical features of normal tension glaucoma and PVL. In severe cases, post-mortem examinations revealed that 75% of premature babies who died shortly after birth had periventricular leukomalacia. These animal models can be used to examine the potential efficacy of new medications in the prevention and treatment of PVL. Common methods for preventing a premature birth include self-care techniques (dietary and lifestyle decisions), bed rest, and prescribed anti-contraction medications. Children and adults who have a rare disease and their caregivers are encouraged to talk about their needs with the medical team and to reach out for the support they require. PVL or periventricular leukomalacia is the softening of; the white brain tissue near the ventricles. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391059/), Visitation, mask requirements and COVID-19 information. Epub 2020 Mar 23. PVL may occur due to lack of blood or oxygen to your childs brain. Chattha AS, Richardson EP: Pathogenesis and evolution of periventricular leukomalacia in infancy . Association between perinatal hypoxic-ischemia and periventricular leukomalacia in preterm infants: A systematic review and meta-analysis. Significant visual involvement classically presents in infants and children with symptoms of visual inattention, diplopia, difficulty with fixating on faces, perception of motion, depth perception4, a characteristic squint11, and difficulty maintaining eye contact12. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The .gov means its official. Nitrosative and oxidative injury to premyelinating oligodendrocytes in periventricular leukomalacia. sharing sensitive information, make sure youre on a federal Pathophysiology of periventricular leukomalacia: what we learned from animal models. 2005 Dec;20(12):940-9. doi: 10.1177/08830738050200120301. Periventricular leukomalacia (PVL) is characterized by the death or damage and softening of the white matter, the inner part of the brain that transmits information between the nerve cells and the spinal cord, as well as from one part of the brain to another. Although the incidence of the most severe cystic form . Taboada D, Alonso A, Olage R, Mulas F, Andrs V. Neuroradiology. Periventricular leukomalacia in adults. However, extent of improvement, if any, is highly dependent on degree of cerebral injury as well as time of diagnosis and of starting rehabilitation. Terms of Use| Because their cardiovascular and immune systems are not fully developed, premature infants are especially at risk for these initial insults. Sullivan P, Pary R, Telang F, Rifai AH, Zubenko GS. De Reuck JL, Eecken HMV. What is periventricular leukomalacia (PVL)? The outlook for individuals with PVL depends upon the severity of the brain damage. Br J Ophthalmol. PVL can affect fetuses or newborns, although premature babies are at greatest risk. [6] One of the earliest markers of developmental delays can be seen in the leg movements of affected infants, as early as one month of age. Table 1: Comparison of characteristic clinical features of anterior and posterior lesions of visual pathway. doi:10.1001/archneur.1978.00500320037008. The 2023 edition of ICD-10-CM G93.89 became effective on October 1, 2022. Premature infants often exhibit visual impairment and motor deficits in eye control immediately after birth. PVL may happen before, during or after birth. Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. Indian J Pediatr. Periventricular leukomalacia (a.k.a white matter injury of prematurity) is injury to the white matter surrounding the ventricles due to a variety of perinatal brain insults affecting preterm babies. As has been discussed, this condition is often mistaken for normal tension glaucoma. The white matter in preterm born children is particularly vulnerable during the third trimester of pregnancy when white matter developing takes place and the myelination process starts around 30 weeks of gestational age.[3]. The disorder is caused by a lack of oxygen or blood flow to the periventricular area of the brain. . Infants with severe PVL suffer from extremely high levels of muscle tone and frequent seizures. Fortunately for Chicago families, Illinois does not put a cap on non-economic damages. Policy. Summary. J Neurol Neurosurg Psychiatry. [6], The fetal and neonatal brain is a rapidly changing, developing structure. . Clipboard, Search History, and several other advanced features are temporarily unavailable. Applicable To. Periventricular leukomalacia (PVL), or neonatal white matter injury, is the second most common central nervous system (CNS) complication in preterm infants, after periventricular hemorrhage.PVL is caused by ischemia in the watershed territory of the preterm infant. 8600 Rockville Pike Neuropharmacology. sharing sensitive information, make sure youre on a federal Virchows Arch A Pathol Anat Histol. Pediatr Res. Your white matter sends information among your nerve cells, spinal cord and other parts of your brain. The disorder is caused by a lack of oxygen or blood flow to the periventricular area of the brain. As previously noted, there are often few signs of white matter injury in newborns. These ophthalmic manifestations are well known to pediatric ophthalmologists. In addition, babies born prematurely, especially before 32 weeks gestation, have a heightened risk of PVL. [9] Seizures are typically seen in more severe cases of PVL, affecting patients with greater amounts of lesions and those born at lower gestational ages and birth weights. The more premature your child is, the higher the risk. Federal government websites often end in .gov or .mil. Distributing copies (electronic or otherwise) of the article is not allowed. There is loss of normal periventricular white matter, with associated gliosis and thinning of the corpus callosum. When you are returned to the Journal, your name should appear at the top right of the page. [2] Gestational CMV infection also produces PVL in neonates.[10]. Your organization or institution (if applicable), e.g. In cases where perinatal hypoxic brain injury has already occurred, use of hypothermia as neuroprotective treatment has been studied16. Careers. 2021 Aug 23;12:714090. doi: 10.3389/fimmu.2021.714090. Consequent cell death and thinning of white matter around the ventricles leaves fluid-filled spaces called lateral ventricles9. The percentage of individuals with PVL who develop cerebral palsy is generally reported with significant variability from study to study, with estimates ranging from 20% to more than 60%. Chhablani PP, Kekunnaya R. Neuro-ophthalmic manifestations of prematurity. [6][8] Many patients exhibit spastic diplegia,[2] a condition characterized by increased muscle tone and spasticity in the lower body. Some children exhibit fairly mild symptoms, while others experience significant disabilities. We propose that the prolonged hypoxia and ischemia produce a "no reflow" phenomenon causing brain edema (more pronounced in the white matter); this resulted in infarctions of white matter in the periventricular arterial end and border zones. Last reviewed by a Cleveland Clinic medical professional on 02/17/2022. Other conditions linked to PVL include: In mild cases, some babies may not have any symptoms. This pathology of the brain was described under various names ("encephalodystrophy", "ischemic necrosis", "periventricular infarction", "coagulation necrosis", "leukomalacia," "softening of the brain", "infarct periventricular white matter", "necrosis of white matter", "diffuse symmetrical periventricular leukoencephalopathy"), and more often by German scientists, but the worldwide dissemination was the term periventricular leukomalacia, introduced in 1962 B. Khurana R, Shyamsundar K, Taank P, Singh A. Periventricular leukomalacia: an ophthalmic perspective. Your childs healthcare provider will need to monitor them over time for any changes to their condition. Periventricular Leukomalacia (PVL) is a condition characterized by injury to white matter adjacent to the ventricles of the brain. National Cerebral Palsy Awareness Month (and Awareness Day on March 25) was created by Reaching for the Stars in 2006. 2. The https:// ensures that you are connecting to the We propose that the prolonged hypoxia and ischemia produce a "no reflow" phenomenon causing brain edema (more pronounced in the white matter); this resulted in infarctions of white matter in the periventricular arterial end and border zones. (For instructions by browser, please click the instruction pages below). Groth SL, Donahue SP, Reddy A, Sarma A, Wushensky C. Periventricular Leukomalacia in Patients With Pseudo-glaucomatous Cupping. Monday, March 18, 2013 Neuroradiology , periventricular leukomalacia. Front Immunol. Huang J, Zhang L, Kang B, Zhu T, Li Y, Zhao F, Qu Y, Mu D. PLoS One. Periventricular leukomalacia is characterized by diffuse injury of deep cerebral white matter, accompanied in its most severe form by focal necrosis. The white matter in the periventricular regions is involved heavily in motor control, and so individuals with PVL often exhibit motor problems. Your last, or family, name, e.g. 4. Periventricular leukomalacia, or PVL, is a type of brain damage that involves the periventricular white matter of the brain. Ongoing therapy helps children live with the condition. Sparing of papillomacular bundle (until late), Hypodensity in periventricular white matter, Increased periventricular signal intensity w/ T2 MRI, Deep, prominent sulci w/ ventriculomegaly. The neuropathologic hallmarks of PVL are microglial activation and focal and diffuse periventricular depletion of premyelinating oligodendroglia. After an early partial recovery from coma, the patients remained in a persistent vegetative state, with a tetrapyramidal syndrome. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease. Common risk factors for PVL are intrauterine infection, dysregulation of cerebral blood flow, chorioamnionitis, and premature membrane rupture6. J Child Neurol. The site is secure. 2020 Apr 30;69(2):199-213. doi: 10.33549/physiolres.934198. All types of volunteers are neededthose who are healthy or may have an illness or diseaseof all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them. [12] Further damage is believed to be caused by free radicals, compounds produced during ischemic episodes. Please enable it to take advantage of the complete set of features! Table 3 lists the findings on OCT that help to differentiate glaucomatous from pseudo-glaucomatous cupping in PVL. Periventricular leukomalacia, also known as white matter injury of prematurity, is a brain injury that occurs prior to 33 weeks of gestation. 3 - Visual Loss: Overview, Visual Field Testing, and Topical Diagnosis. [21] On a large autopsy material without selecting the most frequently detected PVL in male children with birth weight was 1500-2500 g., dying at 68 days of life. Adjustment for refractive error may periodically be needed, as patients with PVL may commonly present with astigmatism or hyperopia17. Purchase A 2007 article by Miller, et al., provides evidence that white-matter injury is not a condition limited to premature infants: full-term infants with congenital heart diseases also exhibit a "strikingly high incidence of white-matter injury. Made available by U.S. Department of Energy Office of Scientific and Technical Information . Additionally, treatment of infection with steroids (especially in the 2434 weeks of gestation) have been indicated in decreasing the risk of PVL.[14]. Periventricular leukomalacia (PVL) is a type of brain injury that is most common in babies born too soon (premature) or at low birthweight. Periventricular leukomalacia (PVL) is a softening of white brain tissue near the ventricles. One of the methods used for grading periventricular leukomalacia on sonographic appearance is as follows: grade 1: areas of increased periventricular echogenicity without any cyst formation persisting for more than 7 days. It is important to differentiate PVL from the following major white matter lesions in the cerebral hemispheres: edematous hemorrhagic leukoencephalopathy (OGL), telentsefalny gliosis (TG), diffuse leukomalacia (DFL), subcortical leukomalacia (SL), periventricular hemorrhagic infarction (PHI), intracerebral hemorrhage ( ICH), multicystic encephalomalacia (ME), subendymal pseudocyst. The National Library of Medicine (NLM), on the NIH campus in Bethesda, Maryland, is the world's largest biomedical library and the developer of electronic information services that delivers data to millions of scientists, health professionals and members of the public around the globe, every day. leukomalacia: ( l-k-m-l'sha ), Disorder involving softening of brain white matter. It is important to note that both periventricular and subcortical leukomalacia corresponds to a continuous disease spectrum.
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