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Neurology. 2010 Apr 27;74(17):1386-91. doi: 10.1212/WNL.0b013e3181dad62d.

Cross-sectional comparison of periventricular leukomalacia in preterm and term children.

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Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada.



To document and contrast the characteristics of preterm and term-born children with cerebral palsy attributed to underlying radiologic periventricular white matter injury (leukomalacia) (PVWMI/PVL).


A comprehensive cerebral palsy population-based registry (REPACQ) for a 4-year inclusive (1999-2002) birth cohort was systematically searched for all children with radiologic evidence for PVWMI/PVL. Clinical features, neurologic subtype, gross motor functional impairment, and comorbidities were compared in those children born preterm (<37 weeks) and those born at term (> or = 37 weeks).


Of 242 children with cerebral palsy in the registry, 213 had available neuroimaging, in which 41 had PVWMI/PVL: 26 preterm born and 15 term born. Neurologic subtype differed significantly between preterm and term-born children with respect to the frequency of spastic hemiplegia (5/26 vs 8/15; p < 0.05) and spastic diplegia (9/26 vs 2/15; p < 0.05). The groups also differed significantly from a functional perspective (Gross Motor Function Classification System for Cerebral Palsy level I-II; 12/26 vs 12/15; p < 0.05). The comorbidity spectrum was similar between the 2 groups except for the occurrence of cortical blindness in the term-born children (3/15 vs 0/26; p < 0.05).


Differences between preterm and term-born children with cerebral palsy with periventricular white matter injury (leukomalacia) suggest that despite a common radiologic pattern, these are different clinicopathologic entities with perhaps a different gestational timing of acquired injury.

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