Imagine a bustling city where all the roads suddenly have major potholes, causing traffic jams and accidents. That’s similar to what happens in the brain with periventricular leukomalacia (PVL).
In this article, we’ll explore how PVL creates these “potholes” in the brain’s white matter. We’ll also dive into the symptoms and causes of PVL, and uncover its strong link to cerebral palsy.
What is Periventricular Leukomalacia?
Periventricular leukomalacia (PVL) is a type of brain injury. It affects white matter near the brain’s ventricles, causing cells to die. This creates holes and empty spaces. Since this area is important for sending signals to the brain, children with PVL often have problems with movement and thinking.
PVL mainly affects premature babies. The smaller the baby at birth, the higher the risk. According to Boston Children’s Hospital, PVL is common in very premature babies with low birth weight. It’s the second most common central nervous system complication in preemies.
Mild periventricular leukomalacia is a less severe form, but it can still cause issues.
Causes of PVL
There are several causes of PVL. The main cause is a lack of blood flow to the brain before, during, or after birth. This lack of blood flow means the brain doesn’t get enough oxygen.
This can happen if the mother has an infection during pregnancy. It can also happen if the baby has trouble breathing after birth.
Other causes of PVL include:
- Inflammation in the baby’s brain
- Changes in blood pressure
- Drug use while pregnant
- Having twins
- Performing a C-section too late
- Inflammation in the umbilical cord
- Early amniotic sac rupture
PVL damage is permanent. Once cells die, they can’t regenerate. But knowing the causes of PVL can help doctors take steps to prevent it.
Symptoms of PVL Brain Damage
The symptoms of PVL brain damage range from mild to severe. They often show up in the first few years of life.
Babies with PVL may have trouble controlling their muscles. They might be very stiff or very floppy. They might have trouble feeding or swallowing.
Some babies with mild periventricular leukomalacia might not have any symptoms at first. But as they grow, you might notice they have trouble with coordination or balance.
Other symptoms of PVL brain damage include:
- Hearing and vision problems
- Trouble with learning and thinking
- Developmental problems
Periventricular Leukomalacia and Cerebral Palsy
PVL can lead to a condition called cerebral palsy (CP). CP affects movement and muscle tone. It happens because of brain damage before, during, or after birth. Periventricular leukomalacia cerebral palsy is a common type of CP in premature babies.
The link between PVL and cerebral palsy is strong—you might say they’re “sister” conditions. According to the Cleveland Clinic, of the 20,000-30,000 children who have PVL, 7,000 develop cerebral palsy.
Treatment for PVL and Cerebral Palsy
There’s no cure for PVL and PVL cerebral palsy. So treatment focuses on managing symptoms and improving a child’s quality of life. For example:
- Physical therapy can strengthen muscles and improve movement.
- Occupational therapy can help a child learn daily skills like dressing and eating.
- Speech therapy helps with talking and swallowing.
Also, a child with periventricular leukomalacia or cerebral palsy can take medications to reduce muscle stiffness and spasms. In severe cases, surgery can correct bone and muscle problems. Children with PVL cerebral palsy might use braces or wheelchairs for better mobility.
Note that neither PVL nor cerebral palsy are progressive. That means they don’t get worse over time. Early, intensive treatment is key. After that, make sure your child gets regular check ups and help from specialists.
Severe vs. Mild Periventricular Leukomalacia
If your child has mild periventricular leukomalacia, there are less “holes” in the white matter. You can expect them to have some challenges, like mild muscle stiffness, slight coordination issues, or subtle learning difficulties. But with patience, support, and proper treatment, many children with mild PVL lead active and fulfilling lives.
Children with severe PVL often have severe muscle issues. It’s like trying to navigate a road full of potholes—there’s going to be mobility problems. Severe PVL causes symptoms like:
- Severe muscle stiffness (spasticity)
- Significant motor and coordination difficulties
- Vision and hearing problems
- Major cognitive impairments.
Your child may need special equipment, like braces or wheelchairs, to assist with mobility.
Is PVL/Cerebral Palsy Preventable?
PVL and cerebral palsy aren’t always preventable. But taking steps like getting adequate prenatal care can reduce the risk. This helps monitor the baby’s health and catch any issues early. For example, avoiding infections in pregnancy is important, because they’re linked to PVL.
In some cases, PVL and cerebral palsy can result from medical malpractice. Examples include not properly monitoring the baby’s oxygen levels, failing to treat infections, or mishandling a difficult delivery.
If you suspect malpractice caused your baby’s periventricular leukomalacia or cerebral palsy, give us a call. We’ll review your case for free, and tell you whether you may be eligible to receive compensation to help cover medical and therapy costs.