White Matter Injury (WMI)
- White matter injury (WMI) is the most common hypoxic–ischaemic lesion observed in preterm infants.
- Historically termed cystic periventricular leukomalacia (c-PVL).
- Also reported in term infants notably focal punctate lesions frequently seen in term infants with congenital heart disease
Historical Context and Terminology
- The term 'periventricular leukomalacia' was introduced by Banker and Larroche in 1962:
- Leuko- (white), -malacia (softening)
- Based on observations of bilateral, often asymmetrical, coagulation necrosis adjacent to lateral ventricles.
- Initially described in infants born beyond 28 weeks' gestation, several weeks old at death, with recorded anoxic events.
Evolution of Understanding
- Classic PVL less frequently identified today:
- In a key study by Paneth et al. (1990), classic PVL changes observed in only 3 out of 15 infants with white matter necrosis.
Imaging and Diagnosis
- Focal white matter damage:
- Characterised by cystic lesions restricted to regions around trigone and occipital horns.
- May extend into frontoparietal white matter, involving optic radiations.
Incidence Trends
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