Neonatal imaging: periventricular leukomalacia: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neonatal imaging: periventricular leukomalacia

Sample item

An ex-preterm toddler has spastic diplegia. MRI shows periventricular white matter thinning, ventricular enlargement with irregular outlines and increased T2 signal around the trigones. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Periventricular leukomalacia

Hypoxic-ischaemic injury to the vulnerable periventricular white matter of preterm infants causes necrosis, which later leaves white matter loss and ventriculomegaly. It underlies spastic diplegia, as the leg fibres lie nearest the ventricle.

Option by option

  • A. Dandy-Walker malformation

    Dandy-Walker shows a large posterior fossa cyst.

  • B. Periventricular leukomalacia (correct)

    Correct. Periventricular white matter loss in an ex-preterm child with diplegia is PVL.

  • C. Lissencephaly

    Lissencephaly is a smooth brain from a migration disorder.

  • D. Holoprosencephaly

    Holoprosencephaly is a failure of forebrain cleavage.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Periventricular leukomalacia. Hypoxic-ischaemic injury to the vulnerable periventricular white matter of preterm infants causes necrosis, which later leaves white matter loss and ventriculomegaly.

Why is "Dandy-Walker malformation" not the answer?

Dandy-Walker shows a large posterior fossa cyst.

Why is "Lissencephaly" not the answer?

Lissencephaly is a smooth brain from a migration disorder.

Why is "Holoprosencephaly" not the answer?

Holoprosencephaly is a failure of forebrain cleavage.

What concept does this question test?

It tests Neonatal imaging: periventricular leukomalacia in Radiology. It underlies spastic diplegia, as the leg fibres lie nearest the ventricle.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatal imaging: periventricular leukomalacia?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.