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  • Title: [The relation between the clinical symptoms and the findings on magnetic resonance in children with periventricular leukomalacia].
    Author: Martí-Bonmatí L, Rodrigo C, Torregrosa A, Menor F, Dosdá R, Poyatos C.
    Journal: Rev Neurol; ; 33(1):22-6. PubMed ID: 11562856.
    Abstract:
    OBJECTIVES: To assess whether there is a relationship between the various clinical symptoms and imaging findings on MR in children with periventricular leukomalacia (PVLM). PATIENTS AND METHODS: We made a retrospective study of 41 consecutive paediatric patients, 19 boys and 22 girls, with an average age of 30.5+/-19 months (range 8 84 months) who had been diagnosed as having PVLM and studied using MR, recording imaging, clinical and epidemiological data. RESULTS: The MR images showed areas of gliosis in all the children (few foci in 68.3% and multiple foci in 31.7%), with cysts in 22%. The changes were seen mainly in the parietal and occipital regions, were bilateral and symmetrical in 80.5%, with ventricular dilatation in 75.6%, atrophy of the parenchyma in 48.8%, Wallerian degeneration in 7.3%, delay in myelination in 31.7%, lesions in the optic radiations in 9.8%, thalamus 12.2% and anomalous venous drainage in 2.4%. The overall degree of involvement on MR was severe in 43.9%, moderate in 31,7% and mild in 24.4%. There was a history of perinatal foetal distress in 56.8%, hyaline membrane disease in 40.5%, intracranial hemorrhage in 35.1%, psychomotor retardation in 58.5%, motor retardation in 29.3%, and squint in 22%. A significant relationship was found only between acute foetal distress and lateralization of the lesions (p= 0.038) and the presence of parenchymatous cysts (p= 0.024). CONCLUSION: The patients with a history of foetal distress had a greater tendency to symmetrical, bilateral involvement with cysts in the white matter of the brain. It was not possible to establish a model for classification of the overall involvement using MR and the data recorded. The imaging findings were not related overall to the patients symptoms.
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