Neurodevelopmental Outcomes of Children with Periventricular Leukomalacia

作者：Imamura Takashi^*; Ariga Hiromichi; Kaneko Mariko; Watanabe Masahiro; Shibukawa Yasuko; Fukuda Yutaka; Nagasawa Katsutoshi; Goto Aya; Fujiki Tomoo

来源：Pediatrics and Neonatology, 2013, 54(6): 367-372.

DOI：10.1016/j.pedneo.2013.04.006

• cerebral palsy (CP)
• magnetic resonance imaging (MRI)
• motor impairment
• periventricular leukomalacia (PVL)
• walking ability

Objectives: To examine the neurodevelopmental outcomes of children with periventricular leukomalacia (PVL). Materials and methods: Twenty-five children diagnosed with grade 1, 2 or 3 PVL on the basis of magnetic resonance imaging (MRI) findings between January 2002 and December 2011 were enrolled and followed from 15 months to 10 years of age.
Results: Of the 25 children, one was a term and 24 were preterm-births. Nine (36%) had spastic diplegia and 12 (48%) had quadriplegia. Ten of the 25 (40%) were able to walk independently at 36 months utilizing short leg braces, whereas 13 children (52%) were unable to walk independently. MRI findings revealed grade 1 PVL in nine (36%), grade 2 in 12 (48%), and grade 3 in four (16%) of the 25 children. Eleven of the 16 children (69%) with grade 2 or 3 PVL had Papile III or IV intraventricular hemorrhage (IVH), and many of these children had severe neurologic motor abnormalities, severe psychomotor delay, and seizures. Five of the nine children (56%) with grade 1 PVL had normal psychomotor development. There were statistically significant differences in the motor impairment and walking ability between the children with grade 1 and those with grade 2 PVL (p = 0.008 and 0.005, respectively).
Conclusion: Most children with grade 2 or 3 PVL had severe neurodevelopmental delays, but attention should also be paid to the 56% of children with grade 1 PVL who presented with normal psychomotor development. Further studies of larger populations, including long-term follow-up, are necessary to evaluate the outcomes of children with PVL.

• 出版日期2013-12