Which condition is the most common ischemic lesion in the immature brain, affecting white matter?

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Multiple Choice

Which condition is the most common ischemic lesion in the immature brain, affecting white matter?

Periventricular leukomalacia reflects a pattern of ischemic injury that hits the white matter around the ventricles in the immature brain. In premature infants, the premyelinating oligodendrocyte precursors and the periventricular white matter are highly vulnerable to hypoxia-ischemia during a critical window of development. This injury disrupts normal myelination, leading to necrosis and often cystic cavitation near the ventricles. That periventricular, white-matter–focused damage is what makes this the most common ischemic lesion in the immature brain. On ultrasound, you may see early diffuse echogenicity in the periventricular white matter that can progress to cystic lesions along the ventricles. Other choices refer to processes that are not primarily ischemic white-matter injuries in newborns: leukodystrophy is a genetic demyelinating disease; subependymal hemorrhage is a bleed from the germinal matrix; cerebellar hypoplasia involves the cerebellum rather than periventricular white matter.

Periventricular leukomalacia reflects a pattern of ischemic injury that hits the white matter around the ventricles in the immature brain. In premature infants, the premyelinating oligodendrocyte precursors and the periventricular white matter are highly vulnerable to hypoxia-ischemia during a critical window of development. This injury disrupts normal myelination, leading to necrosis and often cystic cavitation near the ventricles. That periventricular, white-matter–focused damage is what makes this the most common ischemic lesion in the immature brain. On ultrasound, you may see early diffuse echogenicity in the periventricular white matter that can progress to cystic lesions along the ventricles. Other choices refer to processes that are not primarily ischemic white-matter injuries in newborns: leukodystrophy is a genetic demyelinating disease; subependymal hemorrhage is a bleed from the germinal matrix; cerebellar hypoplasia involves the cerebellum rather than periventricular white matter.

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