Late-Onset Cystic Periventricular Leukomalacia in Premature Infants: A Threat Until Term

Patrick André; Bernard Thébaud; Jocelyne Delavaucoupet; Véronique Zupan; Nathalie Blanc; Anne Marie d'Allest; Caroline Rambaud; Michel Dehan; Thierry Lacaze-Masmonteil

doi:10.1055/s-2001-13633

American Journal of Perinatology, Table of Contents

Am J Perinatol 2001; 18(2): 079-086
DOI: 10.1055/s-2001-13633

ORIGINAL ARTICLES

Late-Onset Cystic Periventricular Leukomalacia in Premature Infants: A Threat Until Term

Patrick André¹ , Bernard Thébaud¹ , Jocelyne Delavaucoupet² , Véronique Zupan¹ , Nathalie Blanc¹ , Anne Marie d'Allest³ , Caroline Rambaud⁴ , Michel Dehan¹ , Thierry Lacaze-Masmonteil¹

¹Service de Pédiatrie et Réanimation Néonatale, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
²Service de Radiologie, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
³Service des Explorations Fonctionnelles, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
⁴Service d'Anatomie Pathologique, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France

Abstract

ABSTRACT

The purposes of this study are (1) to describe a ``late-onset'' form of cystic periventricular leukomalacia eventually appearing in premature infants whose neurological assessments were normal in the first month of life; (2) to retrospectively evaluate its incidence among a large population of premature infants; (3) to suggest that a few unexpected complications of prematurity may trigger the development of white matter damage, even several weeks after birth. Retrospective study in a population of 1452 surviving infants after 5 days born before 33 weeks. We identified 10 cases of late-onset cystic periventricular leukomalacia appearing beyond the first 5 weeks of life. In 8 cases, an intercurrent event associated with a systemic inflammatory response preceded the appearance of cysts: necrotizing enterocolitis (n = 5), septicemia (n = 2 cases), strangulated inguinal hernia in one infant. Neurological surveillance should be repeated until discharge in very preterm infants, especially after the occurrence of an intercurrent complication coming along with a systemic inflammatory response.

KEYWORD

Periventricular leukomalacia - white matter damage - preterm infant - cerebral palsy

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References

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