Cross-sectional comparison of periventricular leukomalacia in preterm and term children.
OBJECTIVE
To document and contrast the characteristics of preterm and term-born children with cerebral palsy attributed to underlying radiologic periventricular white matter injury (leukomalacia) (PVWMI/PVL).


METHODS
A comprehensive cerebral palsy population-based registry (REPACQ) for a 4-year inclusive (1999-2002) birth cohort was systematically searched for all children with radiologic evidence for PVWMI/PVL. Clinical features, neurologic subtype, gross motor functional impairment, and comorbidities were compared in those children born preterm (<37 weeks) and those born at term (> or = 37 weeks).


RESULTS
Of 242 children with cerebral palsy in the registry, 213 had available neuroimaging, in which 41 had PVWMI/PVL: 26 preterm born and 15 term born. Neurologic subtype differed significantly between preterm and term-born children with respect to the frequency of spastic hemiplegia (5/26 vs 8/15; p < 0.05) and spastic diplegia (9/26 vs 2/15; p < 0.05). The groups also differed significantly from a functional perspective (Gross Motor Function Classification System for Cerebral Palsy level I-II; 12/26 vs 12/15; p < 0.05). The comorbidity spectrum was similar between the 2 groups except for the occurrence of cortical blindness in the term-born children (3/15 vs 0/26; p < 0.05).


CONCLUSIONS
Differences between preterm and term-born children with cerebral palsy with periventricular white matter injury (leukomalacia) suggest that despite a common radiologic pattern, these are different clinicopathologic entities with perhaps a different gestational timing of acquired injury.
Lasry
Oliver
O
Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada.
Shevell
Michael I
MI
Dagenais
Lynn
L
D019575:Blindness, Cortical / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002547:Cerebral Palsy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011792:Quebec; D011859:Radiography; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index