Periventricular Leukomalacia (PVL) in the Premature Infant

Baby's head with hand holding ultrasound probe over forehead.

What is PVL

Periventricular leukomalacia (PVL) is a softening of brain tissue near the ventricles. These are fluid-filled chambers in the brain. The condition occurs when brain tissue has been injured or has died. A lack of blood flow to the brain tissue before, during, or after birth causes PVL. It is rarely possible to tell when or why this happens. PVL is sometimes linked to intraventricular hemorrhage.There is no treatment for PVL.

Which babies are at risk for PVL?

PVL can happen in any baby. But the risk is higher in babies who are born premature, especially very low birth weight, younger preemies. Gestational CMV (cytomegalovirus) infection can also cause PVL in newborns.

How is PVL diagnosed?

Healthcare providers can detect PVL with an ultrasound (imaging test) of the head. But sometimes, signs of the condition can’t be seen with an ultrasound right away. So healthcare providers give babies at risk for PVL an ultrasound 4 to 8 weeks after birth. Magnetic resonance imaging (MRI) may also be used to diagnose PVL.

What are the long-term effects?

PVL may lead to problems with physical or mental development. The severity of these problems varies. In some mild cases, doctors detect PVL on imaging tests, but the condition causes no symptoms. In these cases, the baby still needs to be checked from time to time for signs of problems. In the most severe cases, PVL can cause cerebral palsy or other serious physical and mental delays. Only time can tell how severe a child’s disability will be. If your child is diagnosed with PVL, he or she should be checked regularly by a developmental specialist. This can help detect problems early so you and your child can get help early.