Leukoencephalopathy

In multicystic leukomalacia, the cerebral hemispheric white matter is partially or completely replaced with multiloculated cysts separated by strands of fibroglial tissue. Their lumens contain residual macrophages and tissue debris (Fig 14.8).

A porencephalic cyst denotes a large, circumscribed defect in the cerebral wall caused by a vascular insult during the last trimester of gestation. The cyst connects the ventricle with the subarachnoid space. Its wall is lined with gliovascular tissue, and the overlying cerebral cortex may be necrotic but is not malformed (Fig. 14.9).

Diffuse gliosis of the white matter is attributed to early ischemic edema.

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