periventricular

Periventricular is an anatomical descriptor used in neuroscience and neurology to denote tissue, lesions, or processes that occur in the region surrounding the brain's ventricular system. The primary ventricles include the lateral ventricles, the third ventricle, and the fourth ventricle; tissues adjacent to these spaces are termed periventricular. The term is commonly applied to periventricular white matter, but can also refer to periventricular gray matter or periventricular structures in the spinal cord and brainstem.

In neuroimaging, periventricular lesions are frequently assessed for their pattern and distribution. Periventricular white matter lesions are characteristic of demyelinating diseases such as multiple sclerosis, sometimes described as “periventricular” or “Dawson fingers” radiating perpendicular to the ventricles. Periventricular leukomalacia refers to necrosis of periventricular white matter in preterm infants, leading to motor and cognitive impairments. Periventricular edema may arise from hydrocephalus, acute brain injury, or stroke, reflecting raised intracranial pressure or disrupted CSF dynamics.

Clinical relevance: the location of lesions or abnormalities relative to the ventricles helps narrow differential diagnosis and guides management. Periventricular involvement may also be seen in infections, inflammatory conditions, and certain leukodystrophies.

Imaging: MRI is the modality of choice for assessing periventricular pathology, with T2/FLAIR sequences highlighting hyperintense periventricular lesions. CT may show surrounding edema or calcifications in some conditions.