[Periventricular leukomalacia in the newborn infant. Clinical and echographic diagnosis and follow-up].

Periventricular leukomalacia (PVL) is defined as an ischemic lesion of the brain of the preterm infant, characterized by infarction of the deep white matter surrounding the external angle of the lateral ventricles, a watershed area lacking collateral circulation, representing a typical "border zone" of vascular supply. This lesion is considered the neuroanatomic basis of motor and sensory impairments, as spastic diplegia or quadriplegia, mental retardation, visual and auditory deficits. An early diagnosis and the study of the developmental sequence of PVL, are recently become possible by realtime ultrasound scanning. During a period of one year, from 2/1/1986 to 2/1/1987, 136 newborns hospitalized in the Division of neonatology of the Conegliano General Hospital, have been studied by serial ultrasound scans. The incidence of PVL in the whole group was of 2.9% (4 cases); the incidence increased to 5.6% in infants weighing less than or equal to 2.500 gr (median 1.800 gr), and was 12.5% in the newborns less than or equal to 35 weeks of gestational age (median 31.7 weeks g.e.). Females presented PVL in three cases, with a M/F ratio of 1:3. Cranial real-time ultrasound provided a practical and valuable tool for diagnosis and monitoring of PVL, for its accuracy and safety. The sequence of four stage in the evolution of PVL has been confirmed on ultrasound regular scanning: 1) initial echodensity at the external angle of the lateral ventricles, 2) mild normalisation, 3) gradual cavitation and development of cysts, 4) final development of ventriculomegaly.(ABSTRACT TRUNCATED AT 250 WORDS)