Fig. 18

a, b Comparison of (a) Axial T2-weighted image showing periventricular leukomalacia (PVL) with predominantly periventricular white matter volume loss in a 6-year-old boy who sustained a global hypoxic-ischaemic injury as a premature neonate, compared with (b) axial FLAIR image showing predominantly subcortical white matter loss in a 1-year-old boy who sustained a severe partial-prolonged hypoxic-ischaemic injury at term gestation. In the patient born prematurely with PVL (a), there is such severe periventricular white matter volume loss that the cortical mantle at the sulcal depths abuts the ventricular ependymal edges, causing a ‘wavy’ ventricular margin (black arrows). In addition, the width of the sulci is of equal size at their depth as at their surface, with sulci and gyral surfaces remaining parallel. The patient born at term with partial-prolonged hypoxic-ischaemic injury (b) demonstrates preservation of some of the periventricular white matter substance (even though of abnormally high signal) and regular ventricular margins as the cortical mantle at the sulcal depth is separated from the ventricular ependymal edge. There is also ulegyria at the peri-Sylvian regions bilaterally (red dotted arrows)