Q: My 13 months old son is a premature baby. He is unable to crawl and roll. After seven months of his birth, he could only hold his head straight. Now, he is walking with the help of the walker. He is trying to speak and has started responding to sounds. MRI scan was done seven months back and showed no obvious demonstrable infarct or haemorrhage or SOL in brain parenchyma; paucity of periventricular white matter with minimal thinning of body and splenium of corpus callosum leading to focal dilatation and splaying of posterior horns of lateral ventricles, and prominent fronto-parietal sulci and extra cerebral spaces were seen. According to the MRI scan, there would be possibility of mild form of perinatal hypoxic ischaemic brain damage and sequelae condition. We have consulted paediatricians and neurologists. The doctors told us that my son’s condition will improve and has suggested some medicines. What does MRI scan findings mean?

A:The MRI brain scan reveals structural changes in the brain predominantly affecting the white matter, due to impairment in oxygen / blood supply around the birth. These changes are unlikely to progress or worsen. The damage to the nerve fibres in such cases leads to delay in acquiring motor milestones such as neck holding, rolling, sitting, walking etc. Recovery depends upon the severity of the case - in your case, as per your description; the child seems to be doing well. Continue the occupational therapy and avoid massaging the muscles. If the child has no other problems, then no medicines are required. Periodic check-up by your child neurologist to assess his development of language, intelligence, social and motor milestones should be done. As he was preterm, and has PVL changes on the MRI, his hearing and vision should be checked.