Periventricular Leukomalacia (PVL)

Periventricular leukomalacia, or PVL, is a form of brain injury that affects the white matter — the tissue that surrounds and protects the ventricles (fluid-filled chambers) at the center of the brain. White matter plays a critical role in transmitting signals between different parts of the brain and the rest of the body. When white matter is damaged, it can affect movement, coordination, vision, cognition, and behavior.

PVL is most common in premature babies, particularly those born before 32 weeks of gestation, though it can also occur in full-term infants. Premature babies are especially vulnerable because their brains are still developing and the blood vessels supplying white matter are fragile and immature.

The primary cause of PVL is reduced blood flow or oxygen to the developing brain — a condition called ischemia. When blood flow to the white matter is interrupted or reduced, the oligodendrocyte precursor cells (the cells that form the protective myelin coating around nerve fibers) are killed. The result is cysts, scarring, and structural abnormalities in the white matter.

What many parents don't realize is that PVL can result from failures in medical care during pregnancy, labor, delivery, or the newborn period. These include:

• Failure to prevent or treat preterm labor adequately
• Failure to administer antenatal corticosteroids to accelerate fetal lung and brain development in at-risk mothers
• Prolonged oxygen deprivation during delivery
• Severe maternal infection (chorioamnionitis) that was not identified or treated
• Failure to manage respiratory distress syndrome in a premature newborn, leading to fluctuating oxygen and blood pressure levels
• Low blood pressure in a premature newborn that was not promptly identified and treated

PVL often leads to cerebral palsy, learning disabilities, vision problems, and epilepsy. If your premature baby was diagnosed with PVL, a free medical and legal review may reveal whether the injury was preventable. A licensed attorney can work with independent medical experts to evaluate these cases — at no cost to you. Call 1-800-CP-NEEDS or submit a free case review.