What are the forms of perinatal brain injury?
There are two forms of perinatal brain injury: haemorrhages and ischemic lesions. They tend to start a couple of weeks after birth. I discussed different types of bleeds in the page labelled Brain Haemorrhages. As I mentioned within Congenital Malformations and Perinatal Brain Injury, within these two forms, there are four types of perinatal brain injury, and they are as follows:
- Cerebral palsy
- Intraparenchymal haemorrhage
- Periventricular leukomalacia
- Multicystic encephalopathy
Cerebral palsy, unlike other types of brain diseases, may appear unnoticed at birth and may start exhibiting signs later on in life as the brain develops. This injury affects the motor areas of the brain, and there are multiple symptoms of cerebral palsy, which include the following:
- Dystonia (abnormal muscle tone)
- Paresis (muscle weakness)
- Spasticity (muscle spasms)
- Ataxia (loss of control of body movements)
- Athetsosis (writhing movements caused by abnormal muscle contractions)
These symptoms are treatable with physiotherapy and the use of a wheelchair.
Intraparenchymal haemorrhage is a bleed within the brain, and it may originate in the junction between the thalamus and the caudate nucleus of the basal ganglia, and it can extend into the ventricular system and in the subarachnoid space within the meninges. This complication can lead to hydrocephalus (water in the brain). This tends to happen within infants.
Periventricular Leukomalacia (PVL)
Periventricular leukomalacia, like intraparenchymal haemorrhages, also tend to occur most often within premature babies, and this disorder tends to affect the white matter. This leads to infarcts in the brain. A characteristic feature of this disease are chalky yellow plaques that contain necrotic or dead white matter and some degree of mineralisation. Both periventricular leukomalacia and multicystic encephalopathy are linked in that PVL is the milder form, but multicystic encephalopathy is the more severe form.
Multicystic encephalopathy happens when PVL becomes severe enough to involve the grey and white matter and cystic lesions develop across both hemispheres.