Presentation
The patient was sent for a cranial ultrasound with a history of prolonged labor followed by birth asphyxia. It was delivered at 39 weeks of gestation by vaginal delivery. The patient was admitted to the neonatal intensive care unit.
Patient Data
Coronal and sagittal ultrasound scans with a linear probe through the anterior fontanelle show periventricular increased echogenicity with diffuse cystic changes throughout the bilateral cerebral hemispheres involving bilateral deep white matter, indicating grade 4 periventricular leukomalacia. Lateral ventricles are asymmetrical.
Case Discussion
Periventricular leukomalacia, or white matter injury of prematurity, is classified into four different grades. Grade 4 has the worst prognosis, with a high mortality rate. Along with periventricular and deep white matter echogenicity, there will be extensive subcortical cystic spaces.
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