Perinatal brain injuries

• Intraparenchymal hemorrhage

  • Most neurons form in the highly vascular germinal matrix and migrate out to the cortex as they mature

  • If the baby is born prematurely, there is a risk of the friable vessels in the germinal matrix rupturing (because of the proximity of the germinal matrix to the lateral ventricles, there is risk of blood entering the ventricles and even eventually become an arachnoid hemorrhage)

• Periventricular leukomalacia

  • Tiny infarcts in the periventricular area which usually become calcified (which makes them look white, hence the name)

  • If the infarcts are extensive, cysts may form (this is called multicystic encephalopathy)

• Ischemic injury during birth

  • If there is ischemic injury and subsequent recovery it is called ulegyria because the damage occurs deep in the gyri, producing a mushroom shape

  • Ischemia can also occur in the basal ganglia and thalamus, resulting in aberrant myelination

Category: Pathology Notes