Pediatr Res. 2017 Sep 20;12(9):e0184993. There are many ways to receive support: The differentiating features of true glaucoma in adulthood versus pseudoglaucomatous cupping from PVL are described in Table 2. Findings are usually consistent with white matter loss and thinning of periventricular region. Epub 2014 Jun 17. A Cross-Sectional Study in an Unselected Cohort, Neurology | Print ISSN:0028-3878 Periventricular leukomalacia (PVL) is a softening of white brain tissue near the ventricles. Showing results for periventricular-leukomalacia. of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them. What is periventricular leukomalacia in adults? Policy. 'MacMoody'. Preventing or delaying premature birth is considered the most important step in decreasing the risk of PVL. Chhablani PP, Kekunnaya R. Neuro-ophthalmic manifestations of prematurity. PVL may happen before, during or after birth. All Rights Reserved. Pathophysiology of periventricular leukomalacia: what we learned from animal models. Haynes RL, Baud O, Li J, Kinney HC, Volpe JJ, et al. Pathologic changes consisted of infarction and demyelination of periventricular white matter, with associated necrotic foci in the basal ganglia in some cases. Focal PLV consists of localized cell necrosis in periventricular white matter. A preterm baby delivered by caesarian section at 35 weeks gestation with low APGAR scores on MRI ( for seizures) shows extensive cytotoxic edema of the white matter tracts including gangliocapsular, pyramidal tracts and corpus callosum with . The white matter (leuko) surrounding the ventricles of the brain (periventricular) is deprived of blood and oxygen leading to softening (malacia). Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis . Liu GT, Volpe NJ, Galetta SL. Periventricular leukomalacia is caused by insufficient oxygen in the baby (hypoxemia and hypoxia) and/or restricted or decreased blood flow in the brain (ischemia). Cytokine immunoreactivity in cortical and subcortical neurons in periventricular leukomalacia: are cytokines implicated in neuronal dysfunction in cerebral palsy? Chapter: 760-779. It sends information between the nerve cells and the spinal cord, and from one part of the brain to another. Other conditions linked to PVL include: In mild cases, some babies may not have any symptoms. These are the spaces in the brain that contain the cerebrospinal fluid (CSF). For information about participating in clinical research visit, . PVL may occur when not enough blood or oxygen gets to your childs brain. National Institute of Neurological Disorders and Stroke (NINDS). Leuko means white. 2003 May;62(5):441-50. doi: 10.1093/jnen/62.5.441. Periventricular leukomalacia (PVL) is characterized by the death or damage and softening of the white matter, the inner part of the brain that transmits information between the nerve cells and the spinal cord, as well as from one part of the brain to another. When you are returned to the Journal, your name should appear at the top right of the page. Fortunately for Chicago families, Illinois does not put a cap on non-economic damages. Schmid M, Vonesch HJ, Gebbers JO, Laissue JA. Because neural structures are still developing and connections are still being formed at birth, many medications that are successful for treatment and protection in the adult central nervous system (CNS) are ineffective in infants. Treatments focus on minimizing symptoms and improving quality of life. Customize your JAMA Network experience by selecting one or more topics from the list below. Neuropathologic substrate of cerebral palsy. government site. [6], The fetal and neonatal brain is a rapidly changing, developing structure. Consequently, functional defects in patients with PVL are highly dependent on location of insult. Delayed motor development of infants affected by PVL has been demonstrated in multiple studies. Severe white matter injury can be seen with a head ultrasound; however, the low sensitivity of this technology allows for some white matter damage to be missed. Pattern recognition in magnetic resonance imaging of white matter disorders in children and young adults. Most cases of PVL resulting in CP are associated with diffuse apoptotic and relatively small necrotic areas in the infant brain, affecting mostly white matter (23, 92, 135), while After an early partial recovery from coma, the patients remained in a persistent vegetative state, with a tetrapyramidal syndrome. PVL is also the most common cause of cerebral palsy in preterm infants. MeSH higgs-boson@gmail.com. Schellinger D, Grant EG, Richardson JD. Children and adults may be quadriplegic, exhibiting a loss of function or paralysis of all four limbs. Br J Ophthalmol. Periventricular leukomalacia is a brain disorder occurring in prematurely born babies which is characterized by brain damage with softening and death of the inner part of the brain. Periventricular leukomalacia (PVL) is a kind of brain damage that occurs to the inner part of your brain (white matter). https://eyewiki.org/w/index.php?title=Neuro-ophthalmic_Manifestations_in_Adults_after_Childhood_Periventricular_Leukomalacia&oldid=76299, Ipsilateral visual acuity or visual field loss, Ipsilateral relative afferent pupillary defect (RAPD), Vertical cupping in eye with nasal visual field loss, Horizontal band cupping in eye with temporal visual field loss, Variable nerve fiber layer type visual field defects (often nasal step), More prominent Inferior visual field defect (may be temporal), Hourglass type (superior and inferior retinal nerve fiber layer loss first). Learn about clinical trials currently looking for people with PVL at, Where can I find more information about p. Did you find the content you were looking for? Am J Neuroradiol. The associated emotional and financial burden associated with misdiagnosis with glaucoma can significantly impact quality of life of patients. As previously noted, there are often few signs of white matter injury in newborns. There is no specific treatment for PVL. Despite the varying grades of PVL and cerebral palsy, affected infants typically begin to exhibit signs of cerebral palsy in a predictable manner. 2. Periventrivular leukomalacia (PVL) refers to focal or diffuse cerebral white matter damage due to ischemia and inflammatory mechanisms (Volpe, 2009a,c ). It is common in very premature (less than 34 weeks gestational age), low birthweight babies (less than 1500 grams). Premature birth is a strong risk factor for PVL. 2009;98(4):631-635. doi:10.1111/j.1651-2227.2008.01159.x, 17. Minor white matter damage usually is exhibited through slight developmental delays and deficits in posture, vision systems, and motor skills. The outlook for individuals with PVL depends upon the severity of the brain damage. PVL may happen before, during or after birth. 2003 Mar;105(3):209-16. doi: 10.1007/s00401-002-0633-6. Periventricular leukomalacia (PVL), the main substrate for cerebral palsy, is characterized by diffuse injury of deep cerebral white matter, accompanied in its most severe form by focal necrosis. Epub 2020 Mar 23. To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2023 American Medical Association. Taboada D, Alonso A, Olage R, Mulas F, Andrs V. Neuroradiology. 2000;45(1):1-13. doi:10.1016/s0039-6257(00)00134-x, 5. Banker and J. C. Larroche. Although all babies can develop the disease, premature babies are at an increased risk. Periventricular Leukomalacia in Adults: Clinicopathological Study of Four Cases. If the loss of white matter is predominantly posteriorly, there may be colpocephaly long . It sends information between the nerve cells and the spinal cord, and . Ongoing therapy helps children live with the condition. PVL also increases the risk of cerebral palsy, learning disabilities and other problems with development. Periventricular Leukomalacia refers to the damage and cell death in the tissues of the white matter. [6][8] Many patients exhibit spastic diplegia,[2] a condition characterized by increased muscle tone and spasticity in the lower body. Periventricular means around or near ventricles, the spaces in the brain that make Cerebral Spinal Fluid (CSF). Am J Pathol. (https://www.ninds.nih.gov/Disorders/All-Disorders/Periventricular-Leukomalacia-Information-Page). It is thought that other factors might lead to PVL, and researchers are studying other potential pathways. The cause of periventricular leukomalacia isnt clear. These are the spaces in the brain that contain the cerebrospinal fluid (CSF). All Rights Reserved, 1978;35(8):517-521. doi:10.1001/archneur.1978.00500320037008, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine. Neurobiology of periventricular leukomalacia in the premature infant. Approximately 60-100% of children with periventricular leukomalacia are diagnosed with Cerebral Palsy. These ventricles are fluid-filled; they contain CSF or cerebrospinal fluid. Periventricular leukomalacia, also known as white matter injury of prematurity, is a brain injury that occurs prior to 33 weeks of gestation. [1], Animal models are frequently used to develop improved treatments for and a more complete understanding of PVL. PVL is anticipated to become more prevalent due to advances in perinatal care and consequent improved survivorship. Preliminary work suggests a role for glutamate receptors and glutamate transporters in PVL, as has been seen in experimental animals. "Leuko" refers to the brain's white matter. doi: 10.1001/archneur.1978.00500320037008. Kato T, Okumura A, Hayakawa F, Kuno K, Watanabe K. The evolutionary change of flash visual evoked potentials in preterm infants with periventricular leukomalacia. No comments have been published for this article. Periventricular leukomalacia (PVL) is characterized by the death of the brain's white matter due to softening of the brain tissue. National Library of Medicine Prompt diagnosis and treatment of maternal infection during gestation reduces the likelihood of large inflammatory responses. Some children exhibit fairly mild symptoms, while others experience significant disabilities. You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid We studied MRI findings of a periventricular high-signal intensity pattern in 151 adults older than 50 years. However, neuro-ophthalmic presentation of PVL is highly variable. Though periventricular leukomalacia can occur in adults, it is almost exclusively found in fetuses and newborns. It is proposed that the prolonged hypoxia and ischemia produce a "no reflow" phenomenon causing brain edema (more pronounced in the white matter); this resulted in infarctions of white matter in the periventricular arterial end and border zones. Have multi-level lower extremity spasticity, meaning spasticity or high muscle tone in multiple muscle groups in their lower extremities that's affecting their gait. Periventricular Leukomalacia Information Page. The condition involves the death of small areas of brain tissue around fluid-filled areas called ventricles. The clinical model of periventricular leukomalacia as a distinctive form of cerebral white matter injury is important for understanding cognitive and social functioning in typical and atypical development because (i) compared with lesions acquired later in life, the model deals with brain damage of early origin (early-to-middle third trimester . Periventricular Leukomalacia in Adults: Clinicopathological Study of Four Cases. These symptoms include problems controlling movement, developmental delays, learning disabilities and seizures. Groth SL, Donahue SP, Reddy A, Sarma A, Wushensky C. Periventricular Leukomalacia in Patients With Pseudo-glaucomatous Cupping. The more premature the baby, the greater the risk of PVL. Periventricular leukomalacia (PVL) is a softening of white brain tissue near the ventricles. These disorders are . Although the incidence of the most severe cystic form . [5] No agencies or regulatory bodies have established protocols or guidelines for screening of at-risk populations, so each hospital or doctor generally makes decisions regarding which patients should be screened with a more sensitive MRI instead of the basic head ultrasound. 1974 Apr 30;27(4):277-88. doi: 10.1007/BF00690693. Early water breaking or bursting of your membranes (amniotic sac). Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis . Submitted comments are subject to editing and editor review prior to posting. (Image from, This page was last edited on 30 January 2023, at 05:03. Periventricular Leukomalacia (PVL) is a brain abnormality that occurs following an injury to a specific region of the brain. Glial function (and dysfunction) in the normal & ischemic brain. Significant visual involvement classically presents in infants and children with symptoms of visual inattention, diplopia, difficulty with fixating on faces, perception of motion, depth perception4, a characteristic squint11, and difficulty maintaining eye contact12. The ventricles are fluid-filled chambers in the brain. 2015 Apr 30;15:69. doi: 10.1186/s12883-015-0320-6. After an early partial recovery from coma, the patients remained in a persistent vegetative state, with a tetrapyramidal syndrome. Diffuse white matter lesions of the cerebral hemispheres of the brain, accompanied by softening and spreading to the central and subcortical areas are more likely DFL, PHI and ME.[1]. Tight muscles, especially in their legs (. . These animal models can be used to examine the potential efficacy of new medications in the prevention and treatment of PVL. Common methods for preventing a premature birth include self-care techniques (dietary and lifestyle decisions), bed rest, and prescribed anti-contraction medications. Clusters of reduced FA were associated with lower birth weight and perinatal hypoxia, and with reduced adult cognitive performance in the VPT group only. Periventricular leukomalacia causes cell damage to the brain's periventricular tissue as well as a decrease in blood flow. Periventricular leukomalacia (PVL) is a type of brain injury most common in very premature babies. Periventricular leukomalacia (a.k.a white matter injury of prematurity) is injury to the white matter surrounding the ventricles due to a variety of perinatal brain insults affecting preterm babies. The pathological findings in four patients with courses characterized by acute coma and respiratory insufficiency occurring in obscure circumstances . Periventricular leukomalacia causes holes and serious damage to the brain. Since PVL is typically the result of perinatal hypoxic injury, progression and further complications are not common. Children with PVL may live from a few months to a full lifetime. PVL leads to problems with motor movements and can increase the risk of cerebral palsy. But its more common in children whore born prematurely and have a low weight at birth. HHS Vulnerability Disclosure, Help [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. All Rights Reserved. In an Israel-based study of infants born between 1995 and 2002, seizures occurred in 102 of 541, or 18.7%, of PVL patients. Federal government websites often end in .gov or .mil. The extent of signs is strongly dependent on the extent of white matter damage: minor damage leads to only minor deficits or delays, while significant white matter damage can cause severe problems with . Brain Pathol 15: 225-233. . Alternatively, damage to the BBB can occur due to maternal infection during fetal development, fetal infections, or infection of the newly delivered infant. PVL is common in very premature, low birthweight . Disclaimer. Table 1: Comparison of characteristic clinical features of anterior and posterior lesions of visual pathway. Periventricular leukomalacia. Am J Ophthalmol. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. Longitudinal follow-up with repeat visual field and OCT are helpful in differentiating PVL related optic atrophy from normal tension glaucoma. The early signs of PVL include periventricular white matter necrosis followed by the subacute stage with possible intraparenchymal cyst formation and the late stages of parenchymal loss and enlargement of the ventricles. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391059/), Visitation, mask requirements and COVID-19 information. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. [2] Episodes of hypotension or decreased blood flow to the infant can cause white matter damage. It is estimated that approximately 3-4% of infants who weigh less than 1,500g (3.3lb) have PVL, and 4-10% of those born prior to 33 weeks of gestation (but who survive more than three days postpartum) have the disorder. Avoiding premature birth allows the fetus to develop further, strengthening the systems affected during the development of PVL. The site is secure. Zaghloul. The extent of PVL may be further assessed using fMRI with various visual stimuli. Periventricular Leukomalacia (PVL) is a condition characterized by injury to white matter adjacent to the ventricles of the brain. Periventricular leukomalacia (PVL) is a brain injury disorder characterized by the death of the white matter of the brain due to softening of the brain tissue. The typical distribution of PVL has been correlated . Submissions must be < 200 words with < 5 references. By definition, PVL has 2 neuropathologic components: a focal periventricular necrotic component and diffuse gliosis in the . Single-Cell Analysis of the Neonatal Immune System Across the Gestational Age Continuum. Neuropharmacology. PVL is overdiagnosed by neuroimaging studies and the other white matter lesions of the brain are underestimated. Carbon monoxide intoxication was excluded. Therefore, it is essential to raise awareness of PVL as a possible cause of strabismus, visual deficit and cupping in patients with history of prematurity and perinatal complication. Lines and paragraphs break automatically. The periventricular area-the area around the spaces in the brain called ventricles-contains nerve fibers that carry messages from the brain to the body's muscles. Reperfusion of ischemic tissue is associated with vascular injury, increased reactive oxygen and nitrogen species production, and abnormal inflammation5,8. It is a brain injury characterized by necrosis or coagulation of white matter near the lateral ventricles. The destruction or injury to this part of the brain is a strong indicator that a child will develop cerebral palsy. Several cytokines, including interferon-gamma (known to be directly toxic to immature oligodendroglia in vitro), as well as tumor necrosis factor-alpha and interleukins 2 and 6, have been demonstrated in PVL. Last reviewed by a Cleveland Clinic medical professional on 02/17/2022. Acta Paediatr. If you are responding to a comment that was written about an article you originally authored: 2014;62(10):992-995. doi:10.4103/0301-4738.145990, 13. Only 7.8% of patients who had no identified cerebrovascular risk factors and who reported no cerebrovascular symptoms had these MRI periventricular lesions; 78.5% of patients with a history of cerebrovascular risk factors and who had had cerebrovascular symptoms had periventricular patterns. Ganesh S, Khurana R, Wallang B, Sharma S. Ophthalmic Manifestations in Children with Periventricular Leukomalacia. Epub 2002 Nov 20. Progressive multifocal leukoencephalopathy with paramyxovirus-like structures, Hirano bodies and neurogibrillary tangles. After clearing, choose preferred Journal and select login for AAN Members. Adjustment for refractive error may periodically be needed, as patients with PVL may commonly present with astigmatism or hyperopia17. If you are uploading a letter concerning an article: [5], Although no treatments have been approved for use in human PVL patients, a significant amount of research is occurring in developing treatments for protection of the nervous system. Clipboard, Search History, and several other advanced features are temporarily unavailable. Please refer to the article on patterns of . Periventricular leukomalacia (PVL) is a kind of brain damage that occurs to the inner part of your brain (white matter). The most common PVL symptoms appear by six to nine months of age and may include: Your healthcare provider will ask about your childs symptoms and health history. The white matter is the inner part of the brain. 3. PVL or periventricular leukomalacia is the softening of; the white brain tissue near the ventricles. Definition. The disorder is caused by a lack of oxygen or blood flow to the periventricular area of the brain. Abstract. 1991;33(6):478-93. doi: 10.1007/BF00588038. Acta Neuropathol. Jethani J, Jethani M. Flash visual evoked potentials in patients with periventricular leucomalacia in children less than 1 year of age. Periventricular leukomalacia, or PVL, involves injury to the brain. In most hospitals, premature infants are examined with ultrasound soon after birth to check for brain damage. Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment. About 7,000 of these children develop cerebral palsy. Archives of Neurology & Psychiatry (1919-1959), JAMA Surgery Guide to Statistics and Methods, Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA Recommendations, CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic, Global Burden of Skin Diseases, 1990-2017, Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension, Mass Violence and the Complex Spectrum of Mental Illness and Mental Functioning, Organization and Performance of US Health Systems, Spirituality in Serious Illness and Health, The US Medicaid Program: Coverage, Financing, Reforms, and Implications for Health Equity, Screening for Prediabetes and Type 2 Diabetes, Statins for Primary Prevention of Cardiovascular Disease, Vitamin and Mineral Supplements for Primary Prevention of of Cardiovascular Disease and Cancer, Statement on Potentially Offensive Content, Register for email alerts with links to free full-text articles. 'Royal Free Hospital'. PVL is caused by a lack of oxygen or blood flow to the area around the ventricles of the . Some children exhibit relatively minor deficits, while others have significant deficits and disabilities. This article discusses about the causes, symptoms, treatment and prevention of periventricular leukomalacia. Table 2: Comparison of characteristic clinical features of normal tension glaucoma and PVL. 4. Bookshelf Huang J, Zhang L, Kang B, Zhu T, Li Y, Zhao F, Qu Y, Mu D. PLoS One. Learn more about the causes and symptoms of PVL. Currently, there are no treatments prescribed for PVL. PVL is injury to the white matter around the fluid-filled ventricles of the brain. Babies with PVL generally have no outward signs or symptoms of the disorder, but they are at risk for: PVL may be accompanied by a hemorrhage or bleeding in the periventricular-intraventricular area and can lead to cerebral palsy. Table 4: Characteristic features of PVL on CT and on MRI. Laboratory testing is not typically necessary for PVL diagnosis. Novosibirsk, Nauka, 1985 .- 96 p. Hamrick S, MD. Children with PVL should receive regular medical screenings to determine appropriate interventions. White matter disease differs from PVL in that it occurs in certain adults, not babies. Semin Perinatol. Section: 764-779. National Cerebral Palsy Awareness Month (and Awareness Day on March 25) was created by Reaching for the Stars in 2006. J Child Neurol. National Institutes of Health Web Site. [22], Other ongoing clinical studies are aimed at the prevention and treatment of PVL: clinical trials testing neuroprotectants, prevention of premature births, and examining potential medications for the attenuation of white matter damage are all currently supported by NIH funding. The percentage of individuals with PVL who develop cerebral . Theyll also give your child a physical exam. Premature children have a higher risk of PVL. No, I did not find the content I was looking for, Yes, I did find the content I was looking for, Please rate how easy it was to navigate the NINDS website. The Academy uses cookies to analyze performance and provide relevant personalized content to users of our website. Would you like email updates of new search results? Terms of Use| Because their cardiovascular and immune systems are not fully developed, premature infants are especially at risk for these initial insults. Page highlights. Children and adults may be quadriplegic, exhibiting a loss of function or paralysis of all four limbs. The https:// ensures that you are connecting to the An emphasis on prenatal health and regular medical examinations of the mother can also notably decrease the risk of PVL. Diffuse brain damage with softening (diffus leucomalacia, DFL) are found more frequently in children weighing less than 1500 g. However, PVL is not a DFL. In addition, babies born prematurely, especially before 32 weeks gestation, have a heightened risk of PVL. Injury or death of this brain tissue affects the nerve cells that control your movement. Ringelstein EB, Mauckner A, Schneider R, Sturm W, Doering W, Wolf S, Maurin N, Willmes K, Schlenker M, Brckmann H, et al. We propose that the prolonged hypoxia and ischemia produce a "no reflow" phenomenon causing brain edema (more pronounced in the white matter); this resulted in infarctions of white matter in the periventricular arterial end and border zones. Risk factors for white matter changes detected by magnetic resonance imaging in the elderly. Periventricular leukomalacia in adults. View Article 2021;77(2):147-153. doi:10.1016/j.mjafi.2020.05.013, 7. As has been discussed, this condition is often mistaken for normal tension glaucoma. Immediately after an injury, the nervous system generates "pro-inflammatory" cytokines, which are molecules used to coordinate a response to the insult. This pathology of the brain was described under various names ("encephalodystrophy", "ischemic necrosis", "periventricular infarction", "coagulation necrosis", "leukomalacia," "softening of the brain", "infarct periventricular white matter", "necrosis of white matter", "diffuse symmetrical periventricular leukoencephalopathy"), and more often by German scientists, but the worldwide dissemination was the term periventricular leukomalacia, introduced in 1962 B. Neuro-ophthalmic Manifestations in Adults after Childhood Periventricular Leukomalacia. Periventricular leukomalacia (PVL) is a type of brain injury that affects premature infants. They can help connect patients with new and upcoming treatment options. [2] Additionally, hypotension resulting from fetal distress or cesarean section births can lead to decreased blood and oxygen flow to the developing brain. Cerebral visual impairment in PVL typically occurs because of afferent visual pathway injury to the optic radiations, which travel adjacent to the lateral ventricles7. Your organization or institution (if applicable), e.g. However, term infants with congenital cardiac or pulmonary disease are slightly more prone to PVL. 1988 Aug;51(8):1051-7. doi: 10.1136/jnnp.51.8.1051. Surgical intervention is typically not warranted in PVL. PVL involvement of extrastriate association cortex may result in other classical findings of difficulties with object recognition, motion detection, and visual attention10. Information may be available from the following resource: Form Approved OMB# 0925-0648 Exp. PVL may occur before, during or after birth. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Neuroradiology. Your white matter sends information among your nerve cells, spinal cord and other parts of your brain. Jalali, Ali, et al. Magnetic resonance imaging (MRI) is much more effective at identifying PVL, but it is unusual for preterm infants to receive an MRI unless they have had a particularly difficult course of development (including repeated or severe infection, or known hypoxic events during or immediately after birth). "Origin and dynamics of oligodendrocytes in the developing brain: Implications for perinatal white matter injury", "White-matter injury is associated with impaired gaze in premature infants", "[Microglia--new target cells for neurological therapy]", "Abnormal brain development in newborns with congenital heart disease", "Neuroprotection of the developing brain by systemic administration of vasoactive intestinal peptide derivatives", "Gross motor functional abilities in preterm-born children with cerebral palsy due to periventricular leukomalacia", "Developmental sequence of periventricular leukomalacia.
