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, published elsewhere in this issue, addresses the frequency and magnetic resonance imaging (MRI) characteristics...

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