"Adventures, I used to call them. I used to think that they were things the wonderful folk of the stories went out and looked for, because they wanted them, because they were exciting and life was a bit dull...But that's not the way of it with the tales that really mattered, or the ones that stay in the mind. Folk seem to have just landed in them, usually...I expect they had a lot of chances, like us, of turning back, only they didn't. And if they had, we shouldn't know, because they'd have been forgotten."

-Samwise Gamgee, The Lord of the Rings

Friday, May 27, 2011

MRI news

Alina had her MRI last week. We decided to go ahead with it to know where the damage is and to get answers to some questions that were in her medical history that nobody really knew the answers to. What we found out was that she has damage to the white matter of her brain, which is likely due to lack of oxygen at birth, and because of prematurity. Alina was born at 30wks and was quite small. This is the best explanation for what the damage to her brain is called.

Periventricular leukomalacia is a long, difficult-to-pronounce couple of words that describe an injury to the brain that most often affects babies who are born prematurely -- although infants born at term may acquire this as well. Breaking the words down into their basic parts gives a little insight into this diagnosis. The ventricles are normal spaces within the brain that are filled with fluid. "Peri" means around. So, the first word describes a location, namely the area around the lateral ventricles, which are the largest fluid filled spaces of the brain. "Leuko" means white, and "malacia" means soft. Therefore, periventricular leukomalacia (PVL) refers to softening of the white matter of the brain located next to the lateral ventricles.

This softening represents injury to the brain tissue, usually due to lack of oxygen or blood flow to this area of the brain. This poor blood flow may occur prior to delivery, during delivery, or after delivery. Determining when exactly the lack of blood flow occurred is usually impossible. However, the bleeding within the ventricles, which may occur in babies born very prematurely, clearly puts the area around the ventricles at risk for PVL. Unfortunately, there is no effective treatment for PVL. Therefore, most research is directed toward prevention. But even in this arena, there are still no absolutely effective measures to prevent PVL other than preventing premature births.

The periventricular area of the brain primarily contains fibers that control motor functions although there are certainly other functions that reside in this section as well. Therefore, children who develop PVL are at high risk for developmental delays and motor difficulties. PVL remains a major factor in causing cerebral palsy. However, it is impossible to predict what a child will and won't be able to do based upon the extent of PVL. This is why careful developmental follow-up of these children is so crucial. Children with PVL have different outcomes and manifest their delays at different times and with different severity.

So there you have it, Alina's brain is missing some white matter, otherwise its developing and growing normally. And we think she is perfect just the way she is. :)

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