Related Experiment Videos
Cerebral blood flow abnormalities in cerebral palsied children with a normal CT scan
1Department of Pediatrics, State University Hospital, Rigshospitalet, Copenhagen, Denmark.
Insights
Cerebral palsy (CP) patients often show normal CT scans but can have reduced regional cerebral blood flow (CBF). This study found focal hypoperfusion in most CP patients, even with normal imaging, highlighting blood flow
Area of Science:
- Neurology
- Pediatrics
- Medical Imaging
Background:
- Cerebral palsy (CP) is frequently linked to perinatal asphyxia, leading to hypoxic-ischemic encephalopathy or hemorrhage.
- While CT scans reveal lesions in 70-80% of CP patients, this study investigates CP patients with normal CT findings.
Purpose of the Study:
- To investigate regional cerebral blood flow (CBF) in cerebral palsy patients with normal CT scans.
- To correlate observed CBF changes with clinical and etiological factors in CP.
Main Methods:
- Regional cerebral blood flow (CBF) was measured using xenon-133 inhalation and single-photon emission computed tomography (SPECT).
- The study included 20 CP patients (aged 6-19 years) and 9 normal children for comparison.
Main Results:
- Mean CBF was similar between CP patients and controls, but 16 of 20 CP patients exhibited focal hypoperfused areas on SPECT.
- Hypoperfusion patterns varied: preterm infants showed posterior watershed involvement, while term infants had both anterior/posterior and asymmetrical/symmetrical patterns.
- Larger low-flow areas were noted in frontal and fronto-parietal lobes in some children.
Conclusions:
- Focal cerebral hypoperfusion is detectable in CP patients even with normal CT scans.
- The observed hypoperfusion patterns in different infant groups suggest distinct underlying mechanisms.
- There was a poor correlation between clinical presentation and the location of hypoperfused areas, indicating complex pathophysiology in CP.
Abstract:
Cerebral palsy (CP) is often a consequence of a hypoxic-ischemic encephalopathy and/or intracerebral hemorrhage secondary to pre- and peri-natal asphyxia. Hypodense lesions on the CT-scan are found in about 70 to 80% of CP-patients. In the present study, regional cerebral blood flow (CBF) was measured in CP-patients having a normal CT-scan. The aim was to correlate the CBF changes with the clinical and the etiologic findings. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. The mean CBF value in 20 CP-patients, age 6-19 years, was 67 +/- 11 (1 SD) ml/100g/min, the same value as found in the 9 normal children. However, 16 of the 20 CP-patients had focal hypoperfused areas on the tomographic flow map. In the preterm infants (n = 7) the hypoperfused areas were mainly located in the posterior watershed areas, often in one hemisphere only. In the term infants (n = 13) both asymmetrical and symmetrical hypoperfused areas were observed in the anterior and posterior watershed areas. In addition, several children had larger low flow areas in the frontal and fronto-parietal lobes. In both groups, a relatively poor concordance was observed between the clinical findings and the expected location of the low flow area.