**Core Concept**
Periventricular Leukomalacia (PVL) is a form of ischemic brain injury characterized by the necrosis of white matter near the lateral ventricles. It primarily affects premature infants and is a major cause of cerebral palsy.

**Why the Correct Answer is Right**
PVL is most commonly associated with cerebral palsy, particularly spastic diplegia. This is because the injury to the periventricular white matter disrupts the corticospinal tracts, leading to spasticity and weakness of the lower limbs. The damage is typically bilateral and symmetrical, affecting the motor function of the legs.

**Why Each Wrong Option is Incorrect**
**Option A:** Hemiplegia is not the most common outcome of PVL, as the injury typically spares the motor cortex and is more related to the disruption of the corticospinal tracts.
**Option B:** Hydrocephalus is a potential complication of PVL, but it is not the most common outcome. Hydrocephalus occurs when the damage to the periventricular white matter leads to an obstruction of cerebrospinal fluid (CSF) pathways.
**Option C:** Microcephaly is not a direct consequence of PVL. While premature infants with PVL may have a higher risk of microcephaly due to their underlying condition, the two are not directly linked.

**Clinical Pearl / High-Yield Fact**
PVL is a major risk factor for cerebral palsy in premature infants. Early diagnosis and intervention are crucial to prevent long-term neurological damage.

**Correct Answer: C. Hemiplegia**