Pediatric Periventricular Leukomalacia Treatment & Management

Updated: Dec 08, 2020
  • Author: Renjithkumar Kalikkot Thekkeveedu, MD; Chief Editor: Santina A Zanelli, MD  more...
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Medical Care

No medical treatment is currently available for periventricular leukomalacia (PVL). Free-radical scavengers are under investigation to determine if they have a role in preventing oligodendrocyte injury in this condition.


Infants with periventricular leukomalacia require close neurodevelopmental follow-up after discharge from the hospital. Potential consultants include pediatricians, developmental specialists, neurologists, and occupational and physical therapists.



Prevention of premature birth is the most important means of preventing periventricular leukomalacia (PVL).

Prior to birth, diagnosing and managing chorioamnionitis may prevent periventricular leukomalacia. Baud et al reported that betamethasone administered to mothers at 24-31 weeks' gestation, before delivery, significantly reduced the risk of periventricular leukomalacia, suggesting the possible effect of steroids on fetal inflammatory response. [39, 40]

Avoiding maternal cocaine abuse and avoiding maternal-fetal blood flow alterations has been suggested to minimize periventricular leukomalacia.

Following delivery of a premature infant, attempts to minimize blood pressure (BP) swings and hypotension may also be beneficial in preventing periventricular leukomalacia.

Avoidance of prolonged hypocarbia in the mechanically ventilated premature infant may be useful in the prevention of periventricular leukomalacia.


Long-Term Monitoring

Premature infants with evidence of periventricular leukomalacia (PVL) require close developmental follow-up because of the high association with cerebral palsy (CP).

Early intervention strategies carried out by occupational therapists or physical therapists may decrease symptoms, and they may increase the infant's motor function.