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Multiple Choice

You find multiple cystic spaces lateral to the ventricles, these were not present last time you scanned them; they are increasing echogenicity. This could be what?

Periventricular leukomalacia is a pattern of white-matter injury occurring around the lateral ventricles, typically in preterm infants, often after hypoxic-ischemic stress. On neonatal ultrasound you commonly see increased periventricular echogenicity early, which can progress over time to cystic degeneration in the periventricular white matter. The appearance of multiple cystic spaces lateral to the ventricles on serial scans fits this evolving PVL pattern, reflecting loss of periventricular white matter with cyst formation. Hydrocephalus would mainly cause enlargement of the ventricles themselves, not new periventricular cysts. Porencephaly involves a parenchymal cyst that may communicate with the ventricle and is usually a focal lesion rather than multiple periventricular cystic foci. Subdural hematoma is an extra-axial collection along the brain surface, not periventricular cystic changes.

Periventricular leukomalacia is a pattern of white-matter injury occurring around the lateral ventricles, typically in preterm infants, often after hypoxic-ischemic stress. On neonatal ultrasound you commonly see increased periventricular echogenicity early, which can progress over time to cystic degeneration in the periventricular white matter. The appearance of multiple cystic spaces lateral to the ventricles on serial scans fits this evolving PVL pattern, reflecting loss of periventricular white matter with cyst formation.

Hydrocephalus would mainly cause enlargement of the ventricles themselves, not new periventricular cysts. Porencephaly involves a parenchymal cyst that may communicate with the ventricle and is usually a focal lesion rather than multiple periventricular cystic foci. Subdural hematoma is an extra-axial collection along the brain surface, not periventricular cystic changes.