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[Tomodensitometric study of cerebral accidents causing acute hemiplegia in children]
Insights
Computerized Axial Tomography (C.A.T.) differentiates childhood hemiplegia causes. Early C.A.T. scans reveal hemispheric atrophy linked to status epilepticus or cerebral infarction in non-epileptic cases, aiding diagnosis.
Area of Science:
- Neurology
- Pediatric Neurology
- Radiology
Background:
- Acute hemiplegia in childhood presents diagnostic challenges.
- Distinguishing between different etiologies is crucial for appropriate management.
- Computerized Axial Tomography (C.A.T.) is a key neuroimaging modality.
Purpose of the Study:
- To evaluate the utility of C.A.T. in differentiating the causes of acute hemiplegia in children.
- To establish physiopathogenic distinctions between two major categories of infantile hemiplegia.
Main Methods:
- Retrospective analysis of C.A.T. scan findings in pediatric patients with acute hemiplegia.
- Correlation of imaging findings with clinical presentation, specifically status epilepticus.
- Classification of hemiplegia based on association with hemiclonic status epilepticus.
Main Results:
- C.A.T. effectively distinguishes between two main types of cerebral accidents causing hemiplegia.
- Hemiplegias associated with hemiclonic status epilepticus (H. H. and H. H. E. syndromes) typically show contralateral cortico-sub-cortical atrophy, following early hemispheric edema.
- Hemiplegias unrelated to status epilepticus commonly present with cerebral infarction or, rarely, hemorrhage.
Conclusions:
- C.A.T. provides clear physiopathogenic differentiation between infantile hemiplegia subtypes.
- Hemispheric atrophy linked to status epilepticus and cerebral infarction represent distinct etiological pathways for childhood hemiplegia.
Abstract:
Computerized Axial Tomography (C.A.T.) easily distinguishes between the two types of cerebral accident responsible for the two major categories of acute hemiplegia in childhood. 1) In hemiplegias which develop in association with hemiclonic status epilepticus (H. H. and H. H. E. syndromes), in the majority of cases there is an appearance of cortico-sub-cortical atrophy involving the whole hemisphere contralateral to the hemiplegia. This atrophy develops following oedema of the hemisphere which accompanies the initial status epilepticus and which is clearly shown by a very early T.A.C. 2) In congenital or acquired hemiplegias not associated with status epilepticus there is, in most cases, an appearance of cerebral infarction or, very rarely, haemorrhage. It is thus possible, from a physiopathogenic standpoint, to draw a clear distinction between these two major forms of acute infantile hemiplegia. The first (H. H. and H. H. E. syndromes) usually result from hemispheric atrophy which develops in association with a unilateral or predominantly lateral episode of status epilepticus, whilst the second group are usually the result of cerebral infarction.