Grade IV periventricular leukomalacia

Case contributed by Dennis Odhiambo Agolah
Diagnosis certain


Neonate born with low birth weight and preterm for routine screening.

Patient Data

Age: 5 Days
Gender: Male

Increased reflectivity of the bilateral periventricular white matter that is heterogeneously riddled with multifocal variable sized anechoic to hypoechoic cystic lesions some of which are deep seated within the sub-cortical parenchymal areas is noted. The largest cysts (in diameters) measures 12.5 mm, 10.6 mm and 11.7 mm respectively. Caudothalami and their grooves, the mid-brain, brain stem and the posterior fossa plus the choroid plexi as well as the cavum septum pellucidum and the ventrices are uneventful.

Case Discussion

Extensive variable sized cystic lesions (patchy lacunar infarcts) littered within the bilateral periventricular white matter up to the sub-cortical regions with resultant marked hyperechoicity of adjacent non-cystic cerebral parenchymal areas suggesting grade IV cystic periventricular leukomalacia (PVL).

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