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Periventricular Leukomalacia


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Periventricular Leukomalacia

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

These images demonstrate sequelae of severe hypoxic ischemic injury in the neonatal period which resulted in severe periventricular white matter volume loss with ex vacuo enlargement of the lateral ventricles predominantly on the left. There is gray matter volume loss as well. Part of the hemispheric cortex is preserved as a T2 hypointense residual tissue layer. There is a left-sided VP shunt with the tip located within the left lateral ventricle. In addition to the cerebral atrophy, the brainstem and cerebellum is atrophied with dilatation of the fourth ventricle and widening of the foramina of Luschka, bilaterally. Overall the patient is microcephalic. This study was performed as part of an ultrafast protocol for shunted hydrocephalus. Multiplanar T2 haste images are obtained in quick fashion to assess changes in ventricular size.