Periventricular Leukomalacia

Periventricular leukomalacia (PVL) is a type of brain injury most common in very premature babies.

  • PVL is injury to the white matter around the fluid-filled ventricles of the brain. White matter transmits information between nerve cells, the spinal cord, and from one part of brain to the other
  • PVL is common in very premature, low birthweight babies. It is the second most common complication involving the central nervous system in premature infants.
  • PVL can cause damage to the nerve pathways that control motor movements, resulting in muscles that are tight, spastic or resistant to movement, in addition to being weak.
  • Babies with PVL have a higher risk of cerebral palsy and may have learning difficulties and other developmental problems.
  • There is no treatment for PVL. The prognosis varies depending on the severity of the damage to the brain.

What are the symptoms of PVL?

Every child with PVL is unique and will have his or her own set of symptoms, which often become apparent over time as the child develops, rather than all at once.

The most common symptoms of PVL are:

  • trouble with vision and with eye movements
  • trouble with movement, and tight muscles
  • developmental delay that is increasingly apparent over time

What causes PVL?

Although the exact cause of PVL is not known, the condition is thought to be caused when the areas of the brain around the ventricles (the fluid-filled spaces of the brain) don’t get enough blood. This area of the brain is very prone to injury, especially in premature babies whose brain tissue is fragile. The more premature a baby is, the higher the risk for PVL.

Other factors that may be associated with PVL include:

How Boston Children’s approaches PVL

Clinicians in Boston Children’s Fetal Neonatal Neurology Program provide early and accurate diagnosis of PVL and other brain injuries acquired by newborns and young infants. We follow newborns who’ve been seen in the Neonatal Intensive Care Unit (NICU) at Boston Children’s as well as other hospitals. After your baby has been discharged from the NICU, we continue to monitor his neurological progress to provide treatments that will help his long-term development.

Periventricular leukomalacia: Reviewed by Benjamin C. Warf, MD© Boston Children’s Hospital; posted in 2012