43 PERIVENTRICULAR LOW DENSITY AS A PREDICTOR OF NEUROABEHAVIORAL OUTCOME IN VERY LOW BIRTH WEIGHT INFANTS

Abstract

The recent use of CT scanning for assessment of cerebral pathology in the high-risk newborn, has disclosed the frequent occurrence of periventricular low density (PVL), especially in low birth weight infants. It is unclear, however, whether PVL reflects the relative immaturity of poorly myelinated white matter or depicts leukomalacia with the likelihood of an adverse neurologic outcome. In this study we report a preliminary correlation of CT findings with subsequent neurobehavioral outcome in a group of 44 infants weighing <1500 Gm at birth. CT scans were taken at 40 weeks post conceptional age and developmental followup employing the Bayley Scales was obtained on each infant over a period ranging from 7 months to 2 years. MDI or PDI scores below 84 were considered deviant. 14 of 16 infants without PVL or with mild low density localized to the frontal and/or occipital region were normal on followup. All of the 16 infants with diffuse PVL as an isolated finding had deviant mental and/or motor function. Of an additional 10 infants who exhibited PVL combined with increased ventricular size or intracranial hemorrhage, nine had abnormalities of mental and/or motor performance. It appears, therefore, that the presence of diffuse PVL with or without evidence of additional intracranial pathology at 40 weeks PCA may be indicative of potentially adverse neurobehavioral outcome.

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