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Croatian Medical Association - Rijeka branch
ISSN: 0025-7729
Vol. 41, No. 1, 2005, pp. 5-12
Bioline Code: me05001
Full paper language: Croatian
Document type: Research Article
Document available free of charge

Medicina, Vol. 41, No. 1, 2005, pp. 5-12

Ivica Kostović, Nataša Jovanov-Milošević, Mirna Kostović-Srzentić, Zdravko Petanjek


This review deals with recent evidence on vulnerability and the developmental structural plasticity of the human brain:
1. Special laminar indicators of neurogenetic events and transitory fetal structure in preterm infants
2. New concept of vulnerability and organization of the white matter in preterms
3. Structural changes and abnormalities of the "white" matter of the perinatal lesion The correlation between MR images and the histological section demonstrate typical fetal lamination: ventricular and subventricular proliferative zones separated by periventricular fibrilar layer, intermediate zone (fetal "white" matter), "subplate" zone with waiting and growing fibers and cortical plate composed of migratory neurons. The organization of white matter shows tangentional axonal strata in polar regions of hemispheres and periventricular crossroads of commissural, associative and projectional pathways. It is our opinion that pathogenetic factors in hypoxic-ischemic lesions are not only restricted to cellular and infections mechanisms, but they also include the disturbance of extracellular matrix (ECM) and guidance molecules in periventricular crossroads of pathways. The disturbance of ECM leads to the reduction of commissural (especially corpus callosum), associative and projectional pathways and consecutive poor cognitive and neurological outcome. The results described in this review open new possibilities in the diagnosis and follow up of perinatal lesions as well as in the development of new strategies for neuroprotection.

white matter, periventricular crossroads of pathways, developmental vulnerability, structural plasticity

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