Leech R W, Alvord E C
Am J Pathol. 1974 Mar;74(3):591-602.
Periventricular leukomalacia (PVL) usually is manifested as discrete foci of coagulation necrosis of the deep periventricular white matter in the human neonatal brain. During the examination of the brains of 116 infants utilizing an oil red O technic on gelatin-embedded frozen sections, 25 cases of PVL were found with typical foci of coagultion necrosis. Three morphologic varieties of the lesion could be demonstrated. In the first type, rather than being restricted to the periventricular zone, the discrete necrotic foci extended throughout the entire zone of cerebral white matter, even out to just beneath the cortex. The subcortical lesions appeared of short duration, whereas older lesions were always present nearer the ventricle. The second type of lesion presented as linear, some-what serpentine zones of coagulation necrosis radiating into the cerebral white matter. A third type of lesion consisted of a variegated irregular coagulation necrosis which was poorly delineated from more normal tissue. Diffuse pallor of the white matter, the nature of which is still not clear, was associted with the more severe lesions. Although the pathogenesis of PVL is unknown, it is suggested that these new varieties of PVL beyond the discrete periventricular foci of necrosis would be more apt to result in a diffuse loss of white matter and hence mental retardation if the child should survive.
脑室周围白质软化（PVL）通常表现为人类新生儿脑室内深部白质凝固性坏死的离散病灶。在对116例婴儿的大脑进行检查时，利用油红O技术对明胶包埋的冰冻切片进行观察，发现25例PVL伴有典型的凝固性坏死病灶。可以观察到三种形态学类型的病变。在第一种类型中，离散的坏死病灶并非局限于脑室周围区域，而是延伸至整个脑白质区域，甚至延伸至皮质下方。皮质下病变显示为病程较短，而较陈旧的病变总是更靠近脑室。第二种类型的病变表现为线性、有点蜿蜒的凝固性坏死区域，向脑白质放射状分布。第三种类型的病变由斑驳的不规则凝固性坏死组成，与正常组织界限不清。白质弥漫性苍白，其性质尚不清楚，与更严重的病变相关。尽管PVL的发病机制尚不清楚，但有人提出，如果患儿存活，这些超出离散脑室周围坏死病灶的PVL新类型更有可能导致白质弥漫性丧失，进而导致智力发育迟缓。
