Cerebral visual impairment in periventricular leukomalacia: MR correlation.
OBJECTIVE
To evaluate the involvement of central visual pathways in cases of periventricular leukomalacia, and to correlate the neuroradiologic findings with the degree of visual acuity.


METHODS
The MR brain examinations of 27 preterm children affected by cerebral palsy resulting from periventricular leukomalacia and without significant ophthalmologic lesions were reviewed retrospectively to search for possible involvement of the optic radiations and/or of the calcarine cortex. The data were compared with the degree of visual acuity estimated by means of the Teller Acuity Cards test.


RESULTS
Seventeen (63%) of the 27 patients had cerebral visual impairment, which correlated strongly with MR lesions. Quantitative reduction and signal hyperintensity of the peritrigonal white matter and atrophy of the calcarine cortex were present in the more severe cases. In two blind patients, an altered MR signal was detected in the lateral geniculate bodies.


CONCLUSIONS
This study clearly establishes a relationship between specific MR findings and visual impairment in children with periventricular leukomalacia. The finding of hyperintensity in the lateral geniculate bodies was interpreted as an axonal reaction. MR imaging is useful for detecting potential visual impairment and for improving clinical diagnosis.
Uggetti
C
C
Servizio di Neuroradiologia, IRCCS Instituto Neurologico Fondazione C. Mondino, Pavia, Italia.
Egitto
M G
MG
Fazzi
E
E
Bianchi
P E
PE
Bergamaschi
R
R
Zappoli
F
F
Sibilla
L
L
Martelli
A
A
Lanzi
G
G
D001284:Atrophy; D001369:Axons / Q000473:pathology; D001766:Blindness / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002547:Cerebral Palsy / Q000145:classification / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005829:Geniculate Bodies / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000473:pathology; D009900:Optic Nerve / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000473:pathology; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology; D014792:Visual Acuity; D014795:Visual Pathways / Q000473:pathology