Quantitative evaluation of thalami and basal ganglia in infants with periventricular leukomalacia

Quantitative analyses of cross‐sectional areas of the thalami, caudate nuclei, and lentiform nuclei were performed in 29 preterm infants (16 males, 13 females; mean age 29.6 weeks, age range 27 to 24 weeks,) with periventricular leukomalacia (PVL). MRI was carried out in the infants between 9 and 18 months of corrected age and in 16 control infants. Bilateral thalami, caudate nuclei, lentiform nuclei, cerebral hemispheres, and cerebellum were measured by computer. Ratios of the areas of the thalami (Th), caudate nuclei (Ca), lentiform nuclei (Le), and cerebral hemispheres (CH) to that of the cerebellum (Ce) were calculated in each infant. The ratio of Th:Ce was significantly smaller in infants with moderate and severe PVL than in the control group bilaterally. Abnormal intensity areas were not observed in the thalami in any infants with PVL. CH:Ce was also smaller in infants with severe PVL than in the control group. No significant difference was observed between the groups in ratios Le:Ce or Ca:Ce. Results of our study suggest that the volume of the thalami is reduced and that thalamic involvement is present in infants with white matter lesions who have moderate to severe PVL.

[1]  M. Järvelin,et al.  Magnetic resonance imaging of periventricular leukomalacia and its clinical correlation in children , 1997, Annals of neurology.

[2]  N. Paneth,et al.  White matter necrosis in very low birth weight infants: neuropathologic and ultrasonographic findings in infants surviving six days or longer. , 1990, The Journal of pediatrics.

[3]  S. Takashima,et al.  Relationship between periventricular hemorrhage, leukomalacia and brainstem lesions in prematurely born infants , 1989, Brain and Development.

[4]  G. L. Guit,et al.  Value of cranial ultrasound and magnetic resonance imaging in predicting neurodevelopmental outcome in preterm infants. , 1992, Pediatrics.

[5]  K. Sugita,et al.  A comparative magnetic resonance imaging study of the corpus callosum in neurologically normal children and children with spastic diplegia , 1994, Acta paediatrica.

[6]  K. Kuban.  White‐matter disease of prematurity, periventricular leukomalacia, and ischemic lesions , 1998, Developmental medicine and child neurology.

[7]  L. D. de Vries,et al.  Correlation between the Degree of Periventricular Leukomalacia Diagnosed Using Cranial Ultrasound and MRI Later in Infancy in Children with Cerebral Palsy , 1993, Neuropediatrics.

[8]  R. Romero,et al.  Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia. , 1996, American journal of obstetrics and gynecology.

[9]  L. Becker,et al.  Clinicopathological Study of Pontosubicular Necrosis , 1993, Neuropediatrics.

[10]  A. Okumura,et al.  Benign partial epilepsy in infancy. , 1996, Archives of disease in childhood.

[11]  D. Armstrong,et al.  Neuropathologic findings in short-term survivors of intraventricular hemorrhage. , 1987, American journal of diseases of children.

[12]  P. Doubilet,et al.  Maternal Infection, Fetal Inflammatory Response, and Brain Damage in Very Low Birth Weight Infants , 1999, Pediatric Research.

[13]  Kazuyoshi Watanabe,et al.  MRI findings in patients with spastic cerebral palsy. I: correlation with gestational age at birth , 1997, Developmental medicine and child neurology.

[14]  S. Fujimoto,et al.  Magnetic Resonance Imaging Children with Spastic Diplegia: Correlation with the Severity of their Motor and Mental Abnormality , 1991, Developmental medicine and child neurology.

[15]  K. Baba,et al.  Early axonal and glial pathology in fetal sheep brains with leukomalacia induced by repeated umbilical cord occlusion , 1999, Brain and Development.

[16]  U. Roessmann,et al.  In utero Brain Damage: Relationship of Gestational Age to Pathological Consequences , 1994, Developmental medicine and child neurology.

[17]  Kazuyoshi Watanabe,et al.  Benign partial epilepsies in infancy , 2000, Brain and Development.

[18]  M. Adlinolfi.  Infectious diseases in pregnancy, cytokines and neurological impairment: an hypothesis. , 1993, Developmental medicine and child neurology.

[19]  P. Grimaud.  [Cerebral palsy]. , 1972, Pediatrie.

[20]  J. Parisi,et al.  Prenatal symmetrical thalamic degeneration with flexion spasticity at birth , 1983, Annals of neurology.

[21]  K. Yokochi,et al.  Thalamic lesions revealed by MR associated with periventricular leukomalacia and clinical profiles of subjects , 1997, Acta paediatrica.