MEDICAL MALPRACTICE AND PERSONAL INJURY LAW BLOG

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Periventricular Leukomalacia

When a baby is born prematurely or with low birthweight, the baby may face a number of potential birth injuries and developmental problems. One of the birth injuries that often affects premature infants is periventricular leukomalacia. Periventricular leukomalacia is a brain injury in babies that causes permanent damage in areas of the brain. 

It is difficult to learn that your newborn has a brain injury. Even more disturbing for parents is learning that the injury could have been prevented. A medical error or negligence by the doctors can increase the risk of a brain injury. If your child suffered a brain injury and you suspect it was caused by medical mistakes, talk to your birth injury attorneys about ways to hold the doctors and hospitals accountable. 

Periventricular Leukomalacia Birth Injury

Periventricular leukomalacia (PVL) is a type of brain injury. PVL is characterized by damaged white matter near the lateral ventricles in the brain. Necrosis, or death of the white-matter brain cells can be caused by encephalopathy. Hypoxic-ischemic encephalopathy (HIE) is brain damage caused by a lack of oxygen that leads to cell death. 

Ischemic injury that leads to PVL often affects newborns. PVL often occurs in an area of the brain that controls motor function. The damage from periventricular leukomalacia can lead to motor control problems, developmental delays, epilepsy, and cerebral palsy. Vision problems, heart problems, breathing difficulty, and loss of organ function may also occur.

The extent of the injury generally depends on how much white matter was damaged. It may be difficult to identify PVL in a newborn. It may take years before parents realize their child has motor function problems or developmental delays. When a parent realizes the extent of their child’s brain injury, years may have passed since the brain damage occurred. 

In infants, motor function problems may show up in the legs. A child who has been affected by PVL may show tight extension or flexing of the leg joints. Infants with PVL may not exhibit the same sleeping, feeding, or playing positions compared to other children. The motor development signs of PVL may continue as the baby grows. 

What Causes Periventricular Leukomalacia?

Damage to the brain is generally caused by decreased blood flow or decreased oxygen flow to the brain. Hypoxia involves reduced blood oxygenation to the brain. Ischemia is diminished blood flow to the brain. The brain requires a steady supply of oxygen and nutrients in order to function, even as the fetus is developing in the womb. Oxygen deprivation to the brain leads to the death of brain cell tissue and neurons. In PVL, cell death involves white matter tissue in the area of the lateral ventricles of the brain.  

There may be many causes of hypoxia or ischemia that leads to PVL. Any problems that decrease blood or oxygen flow to the fetus can cause brain damage, including oxygen deprivation due to: 

  • Umbilical cord problems
  • Maternal high blood pressure
  • Low blood pressure or hypotension
  • Uterine rupture
  • Preeclampsia
  • Eclampsia
  • Placenta previa
  • Anesthesia errors
  • Infection
  • Delayed C-section

Risks for PVL in Premature or Low Birth-Weight Babies

Periventricular leukomalacia is most common in premature infants or babies with low birth weight. In premature infants or babies with fetal growth restriction, the tissue and organs may not be fully developed. Underdeveloped cardiovascular function and immune system development in premature babies can put them at greater risk for damage caused by hypoxia. 

The blood-brain barrier is a system of cells that regulate nutrient flow to the brain. Damage to the glial cells that support the neurons in the brain may be more common in premature newborns. Problems with the blood-brain barrier can occur with underdeveloped babies, maternal infection, fetal infection, or prenatal infection. 

According to the Centers for Disease Control and Prevention (CDC), a premature birth is defined as a baby born before 37 weeks of pregnancy. In 2019, about 10% of babies were born prematurely. Low birthweight is a baby born weighing less than 5 pounds, 8 ounces. Low birthweight can be caused by premature birth or fetal growth restriction, or a baby who is small for their gestational age. Premature and low birthweight babies have a higher risk for many birth complications, including PVL and other brain injuries.

Long-term Effects of Periventricular Leukomalacia 

The extent of the damage caused by periventricular leukomalacia depends on the extent of brain damage. In minor cases, a baby affected by PVL may be able to live a normal life with only minor deficits. More serious PVL damage can cause serious physical and mental disabilities. The most common long-term effects of PVL damage include: 

In a child with severe disabilities, including cerebral palsy, the treatment options may be limited. Instead, the long-term prognosis may have to focus on raising a child with a brain injury and developmental delays. The costs and care associated with raising a child after a brain injury may continue for the rest of the child’s life. Medical treatment and care may include: 

  • Medication
  • Visits to doctors and specialists
  • Physical therapy
  • Behavioral therapy
  • Special education expenses
  • In-home care specialists
  • Medical equipment
  • Assistive equipment
  • Orthotics
  • Home modifications

Cerebral Palsy and Periventricular Leukomalacia

Cerebral palsy is a general term for many types of conditions that affect motor skills and movement control. There are three main types of cerebral palsy: 

  • Spastic CP is the most common cerebral palsy, and includes 80% of all cerebral palsy cases. It involves issues with specific muscle groups that cause stiffness and effect movement.
  • Ataxic CP accounts for 10% of all cerebral palsy cases, and is characterized by involuntary movement, and problems with balance and depth perception.
  • Athetoid CP also appears in 10% of all cerebral palsy cases, and is characterized by uncontrolled and involuntary movements, slurred speech, and slight muscle tone.

Spastic cerebral palsy is commonly associated with children affected by PVL, including increased tightness and muscle tone in the legs. This can cause difficulty walking, loss of limb function, or paralysis. 

Periventricular Leukomalacia Caused by Medical Malpractice

How does a parent find out if periventricular leukomalacia was caused by medical malpractice? The doctors, nurses, hospitals, or healthcare professionals may not admit to making a mistake that could have caused an injury. It is generally up to the parent to contact an experienced birth injury lawyer to find out if there was a mistake, negligence, or error that caused their child’s brain injury. 

If you suffered negligent medical care in Philadelphia, Baltimore, or Washington, D.C., get the answers you need to help your child. Talk to the experienced medical malpractice attorneys at Gilman & Bedigian. Contact Gilman & Bedigian today for a free consultation.

Periventricular Leukomalacia

A form of brain damage, periventricular leukomalacia, also known as PVL, has an adverse affect on the white matter of babies’ brains. White matter is critical to the brain because it enables the electrical impulse signals that the brain utilizes to control the body. If white matter tissue undergoes cellular decay, then there will be holes or voids in the brain. The holes fill up with fluid, which then results in PVL.

This condition is the main cause of epilepsy and cerebral palsy, and it can cause other permanent mental and physical disabilities as well. About 60% to 100% of babies with PVL will also have a diagnosis of cerebral palsy.

PVL can happen in utero, while a mother is in labor, or shortly after she has given birth. It usually develops between 24-36 weeks gestation, and it sometimes affects babies who are born prematurely, prior to 32 weeks gestation. Other causes include the rupturing of the amniotic sac, umbilical cord inflammation, fetal membrane inflammation, prolonged resuscitation of the infant, asphyxia in pregnancy, labor, or delivery, and antepartum hemorrhage.

Symptoms of Periventricular Leukomalacia

If a baby is exhibiting the following symptoms, then they may have PVL:

  • Vision and hearing issues
  • Loss of coordination
  • Impaired development
  • Muscle contractions or tightness
  • Cognitive impairment

When a baby is born with this condition, doctors usually will not diagnose the baby until months later. They will need to run tests like a cranial ultrasound, where they use sound waves to look at the baby’s brain. They may also do an MRI, or a magnetic resonance imaging test, to see a detailed view of the brain.

Treatment for Periventricular Leukomalacia

There is no treatment for PVL. Once the white matter in the brain decays, it will not repair itself and no treatment can restore it. Since it’s not progressive, the symptoms will not worsen over time.

Although you can’t treat PVL, you can treat conditions that arise as a result of it. For instance, if your child has cerebral palsy, then you can:

  • Send them to occupational and physical therapy, where they will learn how to perform everyday tasks and work on improving their physical functions.
  • Put them on medication, such as muscle relaxants and sedatives.
  • Ensure they undergo surgery if they need it.
  • Purchase medical equipment for them so they can move more easily.

If your child is diagnosed with epilepsy, then you can:

  • Put them on anticonvulsant medications.
  • Put them on a special diet.
  • Ensure they undergo necessary surgery.
  • Install medical devices that may help prevent and control seizures.

Your pediatrician will be able to give you a treatment plan for your child depending on the kind of condition they have.

How Do I Know if Medical Malpractice Caused Periventricular Leukomalacia?

PVL may happen on its own even if your doctor does everything right. Unfortunately, complications arise in pregnancy and during labor without warning.

Sometimes, though, medical malpractice could cause PVL to occur. If any of the following circumstances happened to you, you may have a case:

  • The doctor did not monitor you and your fetus properly during pregnancy and labor.
  • The doctor failed to monitor your baby properly after birth.
  • The doctor did not schedule a C-section when they saw there were issues or they delayed the C-section during labor.

Even if you believe you have the right evidence to support your claim, it may not be enough. It’s best to call a birth injury lawyer who has experience and can give you a professional opinion on whether or not medical malpractice may have occurred.

Many medical malpractice suits get thrown out before they can go to trial. This is because the legal system makes it difficult to sue doctors. They don’t want doctors to be vulnerable and get sued all the time, or else nobody would want to go into the medical field. However, if you have strong proof and a birth injury lawyer on your side, your claim may be seen as valid and you could potentially receive a settlement.

How Much Will I Receive From a Periventricular Leukomalacia Settlement?

If your case goes through, you could receive compensation for things like:

  • Medical bills
  • Loss of companionship and enjoyment of life
  • Pain and suffering
  • Future medical care
  • Loss of earning capacity

You could receive a settlement based on the amount of your economic damages such as your medical bills and future medical care, and your noneconomic damages like pain and suffering. Your lawyer will be able to calculate these for you. Your settlement will be higher if your costs are higher as well. For example, if your child has cerebral palsy and now needs surgery, your settlement could be higher than if your child did not need surgery.

Settlement Offers in a Periventricular Leukomalacia Case

You won’t know what your compensation is going to be until your lawyer successfully procures a settlement for you.

The way the process goes is you will reach out to a birth injury lawyer, and they will ask you what kind of evidence you have to support your claim. This could include photographs of your baby’s injuries, medical bills, and witness statements. You’d send over that evidence and your lawyer would evaluate it. If there’s more evidence to collect, they can assist you.

Then, they’ll get in touch with your doctor, the defendant, and attempt to reach a settlement to cover your damages. The defendant may settle; oftentimes they will to avoid going to court, which is costly and could harm their reputation. Other times, the defendant may try to negotiate for a lower settlement or reject a settlement altogether, at which point you may need to go to court. Your lawyer will explain all of your options and advise you every step of the way.

Why Contact a Birth Injury Lawyer?

PVL can be devastating. You were expecting to give birth to a healthy baby, and now, possibly because of malpractice, your baby is injured and may have lifelong health issues. All you want is for your baby to be happy, so right now, you’re focusing all your energy on them.

At the same time, you don’t want your doctor to get away with what they did. A lawyer will advocate for you and work hard to get you the compensation you deserve. They will represent your best interests so that you can have some peace of mind during this difficult moment.

Periventricular Leukomalacia Birth Injury Attorneys

If your baby has PVL and you believe that medical malpractice was at play before, during, or after you gave birth, then get in touch with Gilman & Bedigian for help. We’re standing by and ready to help.

Contact Gilman & Bedigian 24/7 for a free consultation at (800) 529-6162.

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    Call 800-529-6162 or complete the form. Phones answered 24/7. Most form responses within 5 minutes during business hours, and 2 hours during evenings and weekends.





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