Cerebrovascular development in the human newborn: pathogenetic implications for hypoxic-ischemic neuropathology

Periventricular leukomalacia (PVL) and pontosubicular neuron necrosis (PSN) are clinically and pathologically important brain damages to be prevented even in advanced recent perinatal medicine. The distribution of PVL is very widespread in very low birth weight infants and associated with transient decrease of vessel density as well as immature perforating branches from leptomeningeal cerebral arteries. On the other hand, the localization of karyorrhexis in PSN is wide in immature brains and related to the coexistence of relative immature neurons and mature arterial architecture. These predisposing factors may contribute to make focal microcirculatory and metabolic abnormalities in intracranial hypoperfusion, reperfusion or hyperperfusion.