Periventricular Leukomalacia

  • Etiology: hypotension in watershed / endarterial regions leads to necrosis of periventricular white matter especially near frontal horns and trigones, often bilateral + symmetric (nonhemorrhagic ischemic necrosis, watershed ischemic infarct)
  • Imaging: bilateral and symmetric, periventricular edema / echogenicities early + periventricular cysts late
  • Note: do not confuse with normal peritrigonal blush
  • Complications: cystic encephalomalacia

Radiology Cases of Periventricular Leukomalacia

Head US of periventricular leukomalacia
Coronal (above) and left sagittal (lower left) and right sagittal (lower right) US of the brain shows bilateral increased echogenicity in the periventricular white matter posterior to the lateral ventricles that has multiple cysts present within it bilaterally.