The Impact of Early Neuroimaging and Developmental Assessment in a Preterm Infant Diagnosed with Cerebral Palsy

Area of Science:

• Neonatal neurology
• Pediatric neuroimaging
• Developmental pediatrics

Background:

• Premature infants face elevated risks for cerebral palsy (CP), a condition often diagnosed late, between 18-24 months.
• Standard diagnostic timelines for CP can delay crucial early intervention for affected infants.

Observation:

• A case study details an infant diagnosed with hemiplegic CP despite no initial NICU neurological deficits.
• Neuroimaging at term revealed periventricular leukomalacia, abnormal frontal white matter metabolites (MRS), and reduced fractional anisotropy (FA) via diffusional kurtosis imaging (DKI).
• Early developmental assessments at term, 3 months, and 12 months (Bayley III) showed below-average performance.

Findings:

• Abnormal neuroimaging findings and early developmental delays prompted a referral for intervention services at two months.
• Intensive therapy led to average self-care, mobility, and communication skills by 45 months.
• Despite progress, the child remained below average in visual motor and gross motor coordination.

Implications:

• This case underscores the critical role of early detection using integrated neuroimaging and developmental testing for CP.
• Timely intervention significantly improves functional outcomes in infants with neurological deficits.
• Combined diagnostic approaches enhance the identification of subtle neurological impairments in at-risk infants.