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[Brain circulation in residual cerebral damage. A Doppler ultrasound study]
Insights
Children with severe cerebral palsy exhibit significantly reduced cerebral blood flow velocities. This finding in pediatric cerebral palsy may stem from various underlying factors, impacting neurological function.
Area of Science:
- Neurology
- Pediatrics
- Neuroimaging
Background:
- Cerebral palsy (CP) is a group of movement disorders affecting muscle tone and posture.
- Reduced cerebral blood flow is suspected in CP but requires further investigation.
- Epileptic discharges can also influence cerebral hemodynamics.
Purpose of the Study:
- To investigate cerebral blood flow velocities in children with cerebral palsy (CP) and focal epileptic discharges.
- To compare flow velocities with normative values and identify potential correlations.
Main Methods:
- Transcranial Doppler (TCD) ultrasonography was used to measure flow velocities.
- Measurements were taken in five major cerebral arteries.
- Participants included children with severe bilateral CP, spastic hemiplegia, and focal epilepsy.
Main Results:
- Children with severe bilateral CP showed average flow velocities 55% below normal.
- Reduced flow velocities were observed in at least one cerebral artery on the affected side in 80% of hemiplegic CP cases.
- Reduced velocities were noted in relevant cerebral arteries in children with focal epileptic discharges.
Conclusions:
- Severe cerebral palsy is associated with significantly reduced cerebral blood flow.
- Reduced cerebral blood flow may be a contributing factor in the pathophysiology of CP.
- Potential causes include vascular, metabolic, bioelectric, or pharmacologic factors.
Abstract:
Transcranial Doppler recordings of flow velocities in 5 cerebral arteries were performed in children with cerebral palsy or with focal epileptic discharges. In 22 children with severe bilateral cerebral palsy as an average the flow velocities were 55% of the norm. In 8 of 10 children with spastic hemiplegia, the velocities were reduced at least in one artery of the affected side. 7 of 11 children with a mixed focus and 4 of 18 children with a pure epileptic focus in the EEG presented reduced velocities within the artery belonging to the focus. The results and other studies indicate a reduced cerebral blood flow in severe cerebral palsy with may be caused by vascular, metabolic, bioelectric or pharmacologic factors.