SIGNS AND SYMPTOMS
In PVL, injury to the brain tissue occurs before, during or shortly after birth. However, symptoms are often minimal in young infants. They are usually first noticed months or even years after birth. This is because the brain continues to develop over time as the baby grows and matures.
PVL affects pathways in the brain that control muscle movements and other important body functions. Therefore, babies with PVL are at risk of:
- Motor disorders, such as muscle spasticity (stiffness), weakness, and muscle tone abnormalities
- Coordination problems
- Vision and hearing impairments
- Delayed cognitive development and learning challenges
The specific area of the body involved (right arm, left leg, and so on) depends on the side and specific part of the brain injured.
PVL and Cerebral Palsy
Children with PVL are at risk for cerebral palsy (CP). PVL is the leading cause of CP in preterm infants. CP is a general term for conditions that include motor and cognitive symptoms. These symptoms can vary in severity. CP does not progress with time. However, its symptoms may change with age.
Varied Symptoms
PVL symptoms can vary widely from one child to the next. Some children with PVL may be completely asymptomatic. Some may have very mild symptoms and go undiagnosed. Yet others may have severe symptoms. Sometimes, imaging can show a small degree of PVL, yet there are no clinical symptoms.
However, most infants and children present with delays in movement and developmental milestones. Delays may become increasingly apparent over time. PVL can cause delays in:
- Head control
- Rolling over
- Sitting
- Crawling
- Standing
- Walking
- Speech
- Learning
Vision challenges, abnormal eye movements, and cognitive and behavioral conditions are also common.
DIAGNOSIS / LABORATORY INVESTIGATION
A diagnosis of PVL is confirmed through brain imaging. Brain imaging means taking pictures of the brain. Common imaging methods for PVL include:
Cranial ultrasound (US)
Magnetic Resonance Imaging (MRI)
OUTLOOK
Variability in Outcomes
Outcomes vary widely depending on how severe the initial brain injury was. Some children have mild or no symptoms. They may not even be diagnosed until a later age. Others may have some mild weakness or stiffness in their arms or legs. They may require bracing or physical therapy, but function well otherwise. Still others are on the more severe end of the spectrum. They may have more impairments. They require more support for their activities of daily living.
Environment and Outcomes
The outcomes of PVL can be shaped by many things. Environment is a very important factor. It can affect the brain of a developing newborn. Several studies have shown that an enriched, stimulating environment can affect outcomes for a child. It can lead to better IQ, better language and learning skills, and more. Meanwhile a child who has limited exposures and supports may not fare as well.
An enriching environment can include:
- A good support system
- Human interaction
- Opportunities for reading and language development
Supportive care, therapies and special education programs can also go a long way. They can greatly improve the long-term outcomes of children with PVL.
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