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Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis (more often coagulation) of white matter near the lateral ventricles. [ 1 ] [ 2 ] It can affect newborns and (less commonly) fetuses; premature infants are at the greatest risk of neonatal encephalopathy which may lead to this condition.
Head CT showing periventricular white matter lesions. Leukoaraiosis is a particular abnormal change in appearance of white matter near the lateral ventricles. It is often seen in aged individuals, but sometimes in young adults. [1] [2] On MRI, leukoaraiosis changes appear as white matter hyperintensities (WMHs) in T2 FLAIR images.
White matter is the tissue through which messages pass between different areas of grey matter within the central nervous system. The white matter is white because of the fatty substance (myelin) that surrounds the nerve fibers (axons). This myelin is found in almost all long nerve fibers, and acts as an electrical insulation.
Hyperintensities are commonly divided into 3 types depending on the region of the brain where they are found. Deep white matter hyperintensities occur deep within white matter, periventricular white matter hyperintensities occur adjacent to the lateral ventricles and subcortical hyperintensities occur in the basal ganglia. [citation needed]
Using high field MRI system, with several variants several areas show lesions, and can be spacially classified in infratentorial, callosal, juxtacortical, periventricular, and other white matter areas. [21] Other authors simplify this in three regions: intracortical, mixed gray-white matter, and juxtacortical. [22]
Periventricular means around the ventricle and may refer to: Periventricular leukomalacia , a disease characterized by the death of the white matter near the cerebral ventricles Periventricular nucleus , a composite structure of the hypothalamus
lower white matter hyperintensity volume, indicating less damage to the white matter in the brain increased fractional anisotropy, indicating well-organized and healthy white matter connections.
The white matter with hidden but MRI-visible damage is known as "Normal-appearing white matter" (NAWM) [136] and is where lesions appear. [22] The NAWM is considered a non-visible kind of lesion, produces disability and it is responsive to natalizumab [137] The pathology of the NAWM differs from areas near the lesions or near the cortex.