The neuropathologic and ultrasonographic findings in 22 very low birth weight infants surviving at least 6 days are described from Michigan State University, East Lansing, MI., St. Luke's Roosevelt Medical Center and New York Hospital Cornell Medical Center, NY. White matter necrosis was found in 15 of the 22 subjects and affected hemispheric white matter in ten. The classic features of periventricular leukomalacia were absent from 7 of the 15 infants with necrosis. Intraventricular hemorrhage had occurred in 17. Increased parenchymal echogenicity and ventricular enlargement were present in 67% of infants with white matter necrosis. 
COMMENT White matter necrosis need not be restricted to the periventricular regions and ultrasonographic scanning should include more peripheral areas of the brain.