I am writing this to allow people to know more about diseases and syndromes that children can get at birth. One of my friends gave me this idea when her son ended up having PVL, which is the short name for PeriVentricular Leukomalacia the Definition, is damage and softening of the white matter, the inner part of the brain that transmits information between the nerve cells and the spinal cord, as well as from one part of the brain to another.
What causes this?
It is not clear why PVL occurs. This area of the brain is very susceptible to injury, especially in premature babies whose brain tissues are fragile. PVL may happen when the brain receives too little oxygen. However, it is not clear when the trigger for PVL occurs - before, during, or after birth. Most babies who develop PVL are premature, especially those born before 30 weeks gestation. Other factors that may be associated with PVL include early rupture of membranes(amniotic sac) and infection inside the uterus.
What are the symptoms of PeriVentricular Leukomalacia?
PVL may not be apparent until later months. Each baby may experience symptoms differently. The most common symptom of PVL is spastic diplegia, tight, contracted muscles, especially in the legs. The symptoms of PVL may resemble other conditions or medical problems. Always consult your baby’s physician for a diagnosis.
Which babies should be checked for it?
Premies of 37 weeks Gestational or younger. Babies Weighing between <1000g(2lbs 3oz) and <2500g(approx 5lbs), Small for Gestational Age(FT or PT). Any Complications of prematurity.
What is the Mortality Rate for babies born with PVL?
Survivability correlates with gestational age(11.6% for birth weights <500 g, 50.7% for birth weights of 500-749 g, 83.9% for birth weights of 750-1000 g). Although black infants comprise 15.5% of live births in the United States, they account for 36.8% of babies with birth weights less than 1000 g. ELBW infants are more susceptible to all of the possible complications of premature birth, both in the immediate neonatal period and after discharge from the nursery. Although the mortality rate has diminished with the use of surfactants, the proportion of surviving infants with severe sequelae, such as mental retardation, cerebral palsy, and deafness, has not.
What problems can occur from having PVL?
There are three common problems that occur from children having PVL and those are Cerebral Palsy. Developmental Delays, and Behavioral Problems.
Infants with PVL have varying degrees of mental handicaps. Some may show normal intelligence and development.
However, most have developmental delay and handicaps in their ability to think and learn. Mental handicaps may also have been influenced by injury to other areas of the brain in these sick premature babies.
Among babies with PVL, the type and severity of disability appear gradually over time. It is very important for babies who have been diagnosed with PVL to have frequent developmental assessments. Abnormalities appear gradually.
Severe ones:
Motor Problems:(more with Legs then Arms) tight or stiff muscles, holding legs straight and crossed most of the time, difficulty sitting, slow to crawl, stand, or walk or inability to do these. Abnormal crawling or toe walking, frequent arching of the back, not just when angry or at play.
Slow mental development: does not listen to your voice by age 3-4 months after hospital discharge, does not make different sounds by 8-9 months after discharge, doesn’t seem to understand or say words by one year after discharge.
Seizures
Poor hearing or deafness
poor vision
The less serious ones(possibly not detectable until school age) are:
Poor coordination or balance
specific learning disabilities(such as reading and/or math)
Very short Attention Span
Behavioral Problems
Difficulty with activities that require coordination of the eyes and hand such as catching a ball or copy a simple drawing.
How is PeriVentricular Leukomalacia diagnosed?
With PVL this can be diagnosed by having and mri(a procedure that uses a combination of a large magnet, radio frequencies, and a computer to produce detailed images of internal structures. MRI may show some of the early changes in the brain tissue that occur with PVL.) and/or cranial ultrasound( a painless test that uses sound waves to view the baby’s brain through the fontanelles, the soft openings between the skull bones. With PVL, the ultrasound shows cysts or hollow places in the brain tissue.)
How to cure it or treat it?
At this point, there is no exact treatment nor is there a cure for this.
Only Close monitoring, Physical Therapy.
What Prevention methods can I take?
Recent findings point to a way to help reduce the risk of PVL. Corticosteroid medications are often given to mothers at risk for preterm delivery. The steroid has long been known to help reduce respiratory disease in premature babies. One report found the drug lowered the risk of PVL in very premature babies. Although more studies are needed, this may be a breakthrough in preventing the problems that often result from PVL.