title: The whole spectrum of cystic periventricular leukomalacia of the preterm infant: results from a large consecutive case series.
abstract: OBJECTIVE
  The purpose of this study is to describe features of cystic periventricular leukomalacia (PVL) in a large consecutive cohort study including long-term neurodevelopmental follow-up.
  
  
  METHODS
  We performed a retrospective single-centre cohort study including all preterm infants ≤35 weeks of gestational age with PVL diagnosed by ultrasound scans (US) from a tertiary care university hospital between 1988 and 2012.
  
  
  RESULTS
  The majority of 160 consecutively diagnosed cases had a gestational age between 28 and 32 weeks (60.6%), and male sex was predominant (60.6%). The most common associated clinical findings included respiratory distress syndrome, preterm premature rupture of the membranes, and chorioamnionitis (57.5, 49.4, and 39.4%, respectively). Infants presented with apnoeas in 66.3 and neonatal seizures in 23.1%. Any kind of respiratory support was present in 75.0%. Associated low-grade intraventricular haemorrhage was evident in 33.1, high-grade haemorrhage in 9.4%. Cysts were located on both hemispheres in 75% and PVL grades 3 and 4 were predominant (75.6%). Neurodevelopmental follow-up of 146 cases at a median age of 72 months revealed normal development in 11.0, mental retardation in 50.0, and cerebral palsy in 83.6%. Visual impairment was diagnosed in 21.9% and hearing impairment in one case. A quarter of cases (27.4%) developed seizure disorders. Outcome data were significantly better in unilateral compared to bilateral PVL.
  
  
  CONCLUSIONS
  Long-term neurodevelopmental outcome of bilateral PVL always was adverse and different from unilateral PVL. The latter might be negatively influenced by associated intra- and periventricular haemorrhages.
authors.affiliation: Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria, bernhard.resch@medunigraz.at.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Resch
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Resch
authors.forename: Ute
authors.initials: U
authors.lastname: Maurer-Fellbaum
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pichler-Stachl
authors.forename: Michael
authors.initials: M
authors.lastname: Riccabona
authors.forename: Nora
authors.initials: N
authors.lastname: Hofer
authors.forename: Berndt
authors.initials: B
authors.lastname: Urlesberger
mesh_terms: D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008423:Maternal Age