미숙아에서의 저산소성 허혈성 뇌 손상: 뇌실주위백질연화증의 최근 동향

Abstract

Premature birth may lead to subsequent impairment of developmental events related to myelination, especially as a sequel to periventricular leukomalacia (PVL). PVL results in injury to cerebral white matter, characterized most commonly (80~90% of cases) by a diffuse abnormality consisting of astrogliosis and injury to premyelinating oligodendrocytes. The major long-term motor complication of the focal component of PVL is spastic diplegia, the major prominent motor deficit subsequently observed in premature infants. Although cerebral white matter disease has been considered the principal result of PVL of the premature infant, more recent findings from quantitative MRI studies suggest that gray matter disease is a common and important accompaniment. Here I will review up-to-date delineation of novel neuropathology/pathogenesis, clinical aspects and neuroprotective trials as well as classification and incidence of PVL.