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[Magnetic resonance imaging findings in children with cerebral palsy]
Mei Hou1, Xi-wen Fan, Yu-tang Li
1Qingdao Chilren's Hospital, The Rehabilitation Center For Disabled Children, Qingdao 266011, China.
Insights
Cerebral palsy (CP) types and gestational age correlate with brain abnormalities found via MRI. Magnetic resonance imaging (MRI) aids in identifying brain issues and potential causes of cerebral palsy (CP) in children.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Context:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, with varying clinical presentations and underlying etiologies.
- Understanding the relationship between CP types, gestational age, and brain imaging findings is crucial for diagnosis and management.
- Magnetic resonance imaging (MRI) offers detailed visualization of brain structures, aiding in the identification of abnormalities associated with CP.
Purpose:
- To investigate clinical and neurological abnormalities in children diagnosed with cerebral palsy (CP).
- To correlate specific types of CP and gestational age at birth with radiological abnormalities identified through brain MRI.
- To explore the utility of MRI in revealing brain abnormalities and inferring the etiology of CP.
Summary:
- This study analyzed 104 children with cerebral palsy, examining neurological status, perinatal history, and cranial MRI findings.
- Results indicated significant differences in CP type distribution between term and preterm infants, with spastic diplegia common in preterms and hemiplegia/ataxia in term infants.
- MRI revealed abnormalities in 88% of cases, with specific patterns linked to CP types and gestational age, such as periventricular leukomalacia (PVL) in preterm spastic diplegia and basal ganglia abnormalities in term athetoid CP.
Impact:
- Findings highlight the correlation between brain radiological abnormalities, CP types, and gestational age at birth.
- Brain MRI is confirmed as a valuable tool for detecting underlying brain abnormalities in children with CP.
- This research aids in speculating on the etiology of cerebral palsy, guiding further clinical investigation and therapeutic strategies.
Objective:
To study the clinical and neurological abnormalities in children with cerebral palsy (CP) and to attempt to correlate the types of CP and the gestational age at birth with radiological abnormalities detected by magnetic resonance imaging (MRI) of the brain.
Methods:
This is a hospital-based study, the subjects included 104 children with cerebral palsy who were hospitalized in the Qingdao Rehibilitation Center For Disabled Children. All the 104 hospitalized CP cases (47 with spastic diplegia, 9 with tetraplegia, 15 with hemiplegia, 22 with athetosis, and 11 with ataxia) were examined neurologically and their perinatal history was reviewed. Their cranial MRI findings were studied. The association between the gestational ages, CP types, and the radiological findings were studied.
Results:
The type distribution was significantly different between term- and preterm- infants. Spastic diplegia was the main type in preterm infants while hemiplegia and ataxia were mainly seen in term infants. MRI abnormalities were found in 88 of the 104 cases and abnormal rates of spastic diplegia, tetraplegia, hemiplegia, athetosis, and ataxia were 89.4%, 100%, 100%, 54.5% and 90.9%, respectively. There was no significant difference in abnormal rates between term and preterm groups. Thirty-one of 42 (73.8%) children with spastic diplegia had significant periventricular leukomalacia (PVL), which was more common among preterm-born children (90%). Of the 15 children with hemiplegia, 13 had unilateral lesions on neuroimaging. Spastic tetraplegia was associated with extensive, bilateral, diffuse brain damage. The abnormalities in term-born infants with athetoid cerebral palsy were mainly located in the basal ganglia region whereas the major abnormality in premature infants was PVL. Of the 11 children with ataxic cerebral palsy, 8 cases showed congenital cerebellum dysplasia on brain imaging.
Conclusions:
Radiological abnormalities of the brain were correlated with CP types and the gestational age at birth; MRI scan was useful in revealing underlying brain abnormalities and speculating on the etiology of cerebral palsy.
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