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Periventricular Leukomalacia (Neonatal Cerebral Leukomalacia)

Degeneration of white matter adjacent to the CEREBRAL VENTRICLES following cerebral hypoxia or BRAIN ISCHEMIA in neonates. The condition primarily affects white matter in the perfusion zone between superficial and deep branches of the MIDDLE CEREBRAL ARTERY. Clinical manifestations include VISION DISORDERS; CEREBRAL PALSY; PARAPLEGIA; SEIZURES; and cognitive disorders. (From Adams et al., Principles of Neurology, 6th ed, p1021; Joynt, Clinical Neurology, 1997, Ch4, pp30-1)
Also Known As:
Neonatal Cerebral Leukomalacia; Leukomalacia, Periventricular; Leucomalacia, Periventricular; Cerebral Leukomalacia, Neonatal; Cerebral Leukomalacias, Neonatal; Cystic Periventricular Leukomalacias; Encephalomalacias, Periventricular; Leucomalacias, Periventricular; Leukomalacia, Cystic Periventricular; Leukomalacia, Neonatal Cerebral; Leukomalacias, Cystic Periventricular; Leukomalacias, Neonatal Cerebral; Leukomalacias, Periventricular; Neonatal Cerebral Leukomalacias; Periventricular Encephalomalacia; Periventricular Encephalomalacias; Periventricular Leucomalacia; Periventricular Leucomalacias; Periventricular Leukomalacia, Cystic; Periventricular Leukomalacias; Periventricular Leukomalacias, Cystic; Cystic Periventricular Leukomalacia; Encephalomalacia, Periventricular
Networked: 543 relevant articles (15 outcomes, 57 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1. Hemorrhage
2. Necrotizing Enterocolitis
3. Lung Diseases (Lung Disease)
4. Retinopathy of Prematurity (Retrolental Fibroplasia)
5. Enterocolitis

Experts

1. Volpe, Joseph J: 13 articles (02/2015 - 04/2002)
2. Jensen, Frances E: 9 articles (04/2015 - 04/2002)
3. Ohlsson, A: 8 articles (01/2008 - 01/2000)
4. Rosenberg, Paul A: 7 articles (03/2014 - 04/2002)
5. Vohr, Betty R: 7 articles (12/2011 - 04/2003)
6. Pammi, Mohan: 6 articles (01/2020 - 03/2013)
7. Folkerth, Rebecca D: 6 articles (02/2015 - 07/2004)
8. Chen, Hui-Jin: 6 articles (01/2013 - 06/2008)
9. Qian, Long-Hua: 6 articles (01/2013 - 06/2008)
10. Ehrenkranz, Richard A: 6 articles (12/2011 - 07/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Periventricular Leukomalacia:
1. SteroidsIBA
2. ErythropoietinFDA Link
3. Nitric Oxide (Nitrogen Monoxide)FDA Link
07/25/2006 - "Both p75TNFalphaR2 and p55TNFalphaR1 receptors and nitric oxide may be implicated in the pathogenesis of periventricular leukomalacia."
04/01/2011 - "Children treated with inhaled nitric oxide had previously been shown to have decreased intraventricular haemorrhage and periventricular leukomalacia as newborns and decreased cognitive impairment at 2 years (L.W. "
11/27/2003 - "There was no significant difference between the nitric oxide and placebo groups in the overall incidence of intraventricular hemorrhage and periventricular leukomalacia (33.3 percent and 38.2 percent, respectively), but the group given inhaled nitric oxide had a lower incidence of severe intraventricular hemorrhage and periventricular leukomalacia (12.4 percent vs. 23.5 percent; relative risk, 0.53; 95 percent confidence interval, 0.28 to 0.98; P=0.04). "
07/07/2005 - "In a previous randomized, controlled, single-center trial of premature infants with the respiratory distress syndrome, inhaled nitric oxide decreased the risk of death or chronic lung disease as well as severe intraventricular hemorrhage and periventricular leukomalacia. "
07/27/2006 - "However, for infants with a birth weight between 1000 and 1250 g, as compared with placebo, inhaled nitric oxide therapy reduced the incidence of bronchopulmonary dysplasia (29.8 percent vs. 59.6 percent); for the cohort overall, such treatment reduced the combined end point of intracranial hemorrhage, periventricular leukomalacia, or ventriculomegaly (17.5 percent vs. 23.9 percent, P=0.03) and of periventricular leukomalacia alone (5.2 percent vs. 9.0 percent, P=0.048). "
4. LipopolysaccharidesIBA
5. GlucocorticoidsIBA
6. Neuroprotective AgentsIBA
7. Adrenal Cortex Hormones (Corticosteroids)IBA
8. alpha- Amino- 3- hydroxy- 5- methyl- 4- isoxazolepropionic Acid (AMPA)IBA
9. Memantine (Namenda)FDA Link
10. Glial Cell Line-Derived Neurotrophic Factor (GDNF)IBA

Therapies and Procedures

1. Neonatal Intensive Care
06/01/2004 - "Despite rapid advances in the management of preterm infants, periventricular leukomalacia (PVL) remains a considerable problem in neonatal intensive care. "
08/01/1998 - "Three hundred and forty-nine infants admitted to a Division of Neonatal Intensive Care who were screened for periventricular leukomalacia. "
12/10/2013 - "Since the introduction of neonatal intensive care in the 1970s, there has been a pronounced decrease in overall mortality of premature infants as well as a decrease in the incidence of severe white matter injury, best known as cystic periventricular leukomalacia (c-PVL).(1) While cranial ultrasonography readily visualizes large lesions in the white matter (periventricular hemorrhagic infarction and c-PVL), this technique is not sufficiently sensitive to recognize the much more common and less severe noncystic white matter lesions.(2) The absolute number of extremely preterm infants is increasing because of improved survival rates.(e1.) "
07/12/2016 - "There were no differences between the immediate delivery and deferred delivery groups in any other infant mortality outcome (stillbirth, neonatal mortality, postneonatal mortality > 28 days to discharge), individual neonatal morbidity or markers of neonatal morbidity (cord pH less than 7.00, Apgar less than seven at five minutes, convulsions, interventricular haemorrhage or germinal matrix haemorrhage, necrotising enterocolitis and periventricular leucomalacia or ventriculomegaly).Some important outcomes were not reported, in particular infant admission to neonatal intensive care or special care facility, and respiratory distress syndrome. "
2. Positive-Pressure Respiration (Positive End-Expiratory Pressure)
11/01/2022 - "The pooled analysis suggested a significant reduction for brain injury (a combination of intraventricular haemorrhage and periventricular leucomalacia) (RR 0.65 (0.48 to 0.89), p=0.006) and for intraventricular haemorrhage (RR 0.69 (0.50 to 0.96), p=0.03) in infants receiving positive pressure ventilation with an RFM versus no RFM. "
01/01/2020 - "Secondarily, we assessed the effects of lactoferrin supplementation to enteral feeds on the duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later. "
02/20/2015 - "To determine the effects of oral lactoferrin used to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later.2. To determine the adverse effects of oral lactoferrin in the prophylaxis of neonatal sepsis and/or NEC.When"
01/01/2017 - "Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1. To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later2. "
3. Aftercare (After-Treatment)
4. Perinatal Care
5. Artificial Respiration (Mechanical Ventilation)