Brain injury in the premature infant consists of multiple lesions, principally germinal matrix-intraventricular hemorrhage, posthemorrhagic hydrocephalus, and periventricular leukomalacia (PVL). The last of these now appears to be the most important determinant of the neurologic morbidity observed in survivors of birth weight <1500 g. Indeed, of these very low birth weight infants, ∼10% later exhibit cerebral palsy, and ∼50%, cognitive and behavioral deficits.1–5 The focal necrotic lesions of PVL deep in the cerebral white matter correlate well with the cerebral palsy, whereas the cognitive/behavioral deficits may relate to more diffuse white matter injury observed with PVL (see below). The nature of the relationship between the diffuse white matter injury and the cognitive/behavioral deficits is complex and not entirely understood (see below). The current report of the Hammersmith group by Counsell et al,6 published elsewhere in this issue, addresses the frequency and magnetic resonance imaging (MRI) characteristics...
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July 2003
Commentaries|
July 01 2003
Cerebral White Matter Injury of the Premature Infant—More Common Than You Think
Joseph J. Volpe, MD
Joseph J. Volpe, MD
Children’s Hospital
Harvard Medical School
Boston, MA 02115
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Reprints requests to (J.J.V.) Department of Neurology, Fegan 1103, Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: joseph.volpe@tch.harvard.edu
Pediatrics (2003) 112 (1): 176–180.
Article history
Received:
February 03 2003
Accepted:
February 03 2003
Citation
Joseph J. Volpe; Cerebral White Matter Injury of the Premature Infant—More Common Than You Think. Pediatrics July 2003; 112 (1): 176–180. 10.1542/peds.112.1.176
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