Case 107: Periventricular Leukomalacia Grade IV || Ultrasound

        

Clinical Features:

1 month & 8 days old child was sent with the history of

- Prolonged labour.

- Perinatal asphyxia & hypoxic ischemic encephalopathy. 

- NICU support.

- Birth weight: ~ 3 kg.

Ultrasound Features:

- Areas of increased periventricular echogenicity.

- Extensive cystic lesions in fronto-parieto-temporo-occipital lobes extending into the deep white matter.

Remember:

Sonographic classification of PVL adapted from de Vries et. al.

Grade 1:  Increased periventricular echogenicity for ≥7 days; No cyst.

Grade 2:  Increased periventricular echogenicity; Small periventricular cysts.

Grade 3:  Increased periventricular echogenicity; Extensive periventricular cysts in the occipital and frontoparietal regions.

Grade 4:  Increased periventricular echogenicity & extensive cystic lesions extending into the deep white matter.

Ultrasound Diagnosis:

Periventricular Leukomalacia Grade IV 

Ultrasound Images:

Areas of increased periventricular echogenicity with extensive cystic lesions in fronto-parieto-temporo-occipital lobes extending into the deep white matter.

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