Periventricular leukomalacia. A one-year autopsy study.

We review the frequency and distribution of periventricular leukomalacia (PVL) in consecutive neonatal autopsies in a complete 12-month period. Periventricular leukomalacia occurred in 88% of the high-risk infants. The demographic factors that define risk are a birth weight between 900 and 2,200 g and a survival of six days or more. Virtually all infants with PVL suffered severe clinical insults, and/or had additional necrotic lesions in their viscera. Preferentially, PVL occurs in the cerebral axons in the occipital and sensory-motor radiations. The frequency with which this lesion is found at autopsy may correspond to the frequency with which visual, auditory, and motor dysfunctions occur in surviving premature infants. Electrophysiologic investigations of the high-risk premature infant seem warranted.