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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(5):996-1002.
Periventricular Leukomalacia and Cerebral Palsy in Preterm Infants.
Han, Tai Ryoon , Bang, Moon Suk , Lim, Jae Young , Yoon, Bo Hyeon , Kim, In Won
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea.
2Department of Obstetrics, Seoul National University College of Medicine, Korea.
3Department of Diagnostic Radiology, Seoul National University College of Medicine, Korea.
미숙아의 뇌실주위 백질연화증과 뇌성마비의 연관성에 대한 연구
한태륜, 방문석, 임재영, 윤보현*, 김인원**
서울대학교 의과대학 재활의학교실, 산부인과학교실* 및 진단방사선과학교실**

As the survival rate of preterm infants increasing, much perinatologic concern has been paid to the possibility of their getting into cerebral palsy. The purpose of this study is to determine the relationship between the early periventricular abnormalities and the incidence of cerebral palsy among preterm infants, and then to estimate the value of periventricular leukomalacia(PVL) as the prognostic factor by verifying the clinicopathological correlation of it with cerebral palsy. We have selected 174 cases with periventricular abnormality in early ultrasonographic findings among the survival preterm infants. 163 of them were followed up successfully to verify the incidence of cerebral palsy. Sequential ultrasonographic observations had been made at the interval of 7 or 10 days. Periventricular abnormalities could be classified into three types, which consist of the PVL(including cystic PVL), suspicious PVL, and periventricular echodensity without tissue loss. Associated lesions such as intraventricular hemorrhage, ventriculomegaly, brain atrophy were evaluated. Diagnosis of cerebral palsy was confirmed after following up more than 2 years of age, and the correlations of periventricular abnormalities with the clinical type and severity of cerebral palsy were analyzed. The 24.5% (40/163) of our samples revealed periventricular leukomalacia and the 17.8% (29/163) of them were diagnosed as cerebral palsy. The 65% (26/40) of preterm infants with definite PVL were cerebral palsy and their relative risk ratio for cerebral palsy is 26.7. Without PVL, there were no explicit correlations between cerebral palsy and associated abnormalities. Most cases with cerebral palsy turned out to be the spastic diplegia. In the cases with cystic lesions especially, the clinical outcome appear to be more severe. We've reached the point that the presence of PVL in preterm infants had a strong correlation with the development of cerebral palsy. Moreover, the association with cystic lesions is not only a strong correlation with cerebral palsy, but also a poor prognostic value for functional outcome.

Key Words: Periventricular leukomalacia, Cerebral palsy, Ultrasonography


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