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[Findings on magnetic resonance in spastic cerebral palsy]
J Ramos1, M J Belmonte, E Cassinello
1Hospital Torrecárdena de Almería, Almería, 04009, España.
Insights
Magnetic resonance imaging (MRI) findings in cerebral palsy (CP) correlate well with gestational age, CP type, and cause. This study identified specific lesion patterns linked to prematurity and hypoxic-ischemic events in children with CP.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Context:
- Cerebral palsy (CP) is a group of movement disorders impacting muscle tone and movement.
- Cerebral palsy diagnosis often relies on clinical assessment and neuroimaging.
- Understanding lesion patterns on magnetic resonance (MR) aids in predicting outcomes and etiology.
Purpose:
- To investigate the types of lesions identified by MR in children diagnosed with spastic cerebral palsy.
- To correlate these MR findings with the type of CP, gestational age at birth, and the underlying etiology.
- To establish the diagnostic utility of MR imaging in characterizing cerebral palsy.
Summary:
- A retrospective review of 72 patients with spastic CP revealed various lesion patterns on MR imaging.
- Periventricular leukomalacia (PVL) was common in premature infants with spastic tetraplegia and diplegia.
- Hypoxic-ischemic encephalopathy was associated with parasagittal lesions, diffuse multicystic encephalomalacia, and basal ganglia lesions.
Impact:
- MR imaging findings provide valuable insights into the pathogenesis of cerebral palsy.
- Correlation of MR findings with clinical data aids in understanding the developmental trajectory of affected children.
- This study reinforces the importance of MR imaging in the comprehensive evaluation and management of cerebral palsy.
Objectives:
To study the types of lesion found on magnetic resonance (MR) in cerebral palsy (CP) and their correlation with a the type of CP, gestational age at birth and aetiology.
Patients And Methods:
We made a retrospective review of all patients over one year in age, diagnosed as having spastic CP, who were seen in a paediatric neurology clinic between 1987 and 1998. The MR were evaluated blindly using data from the clinical history.
Results:
Seventy two patients fulfilled criteria for inclusion in the study. The following results were obtained (all associations were statistically significant with p<0.01):1. Patterns of lesion: MR findings were classified into one of the following patterns: parasagittal lesion (7), diffuse multicystic encephalomalacia (4), periventricular leukomalacia (PVL) (26), bilateral dilatation of the basal ventricles without alteration of the signal from the periventricular white matter (5), bilateral lesions in the basal ganglia (5), focal multicystic encephalomalacia (limited to one vascular area) (4), unilateral lesions of hypersignal in the white matter (4), unilateral dilation of a lateral ventricle with or without homolateral cortical atrophy (3), malformations/disorders of migration (7), normal (7). 2. Correlation of the findings with the gestational age and type of CP: a) Spastic tetraplegia: 64% of the premature babies showed PVL. In newborn babies at term the lesions were more varied. b) Spastic diplegia: 80% of the premature babies had PVL and 83% of newborn babies at term had normal MR. c) Spastic hemiplegia: 81% had unilateral lesions. 3. Correlation with the aetiology: 62% of the cases of parasagittal lesions, diffuse multicystic encephalomalacia and bilateral lesions of the basal ganglia were due to hypoxic-ischemic encephalopathy.
Conclusion:
The MR findings in CP show good correlation with gestational age, type of CP and aetiology.