Hemiparetic Cerebral Palsy: Etiological Risk Factors And Neuroimaging

Abstract

The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP), was to verify the etiological risk period for this disease. Etiological risk factors (ERF) were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the prenatal and perinatal period was 41% and no ERF was 18% of the cases. The computerized tomographic scan (CT) and MRI were performed on all the patients, who were then classified according to their etiopathogenic data: CT1 = normal (18%); CT 2= unilateral ventricular enlargement (25%); CT 3 = cortical/ subcortical cavities (28%); CT4= hemispheric atrophy and other findings (14%); CT 5 = malformations (15%). CT 5 was associated with physical malformations beyond the central nervous system and with prenatal ERF's , while CT 2 was associated with the perinatal ERF's, mainly in premature births. Magnetic resonance imaging was performed on 57 patients and demonstrated a good degree of concordance with the CT. Etiology remained undefined in only 37% of the cases after neuroimaging was related to ERF. A high perinatal RF frequency (59%) was observed and emphasized the need for special care during this period.5912934Kuban, K.C.K., Leviton, A., Cerebral palsy (1994) N Engl J Med, 330, pp. 188-195Griffiths, M., Clegg, M., (1988) Cerebral Palsy: Problems and Practice, , London: Souvenir PressUvebrant, P., Hemiplegic cerebral palsy: Aetiology and outcome (1988) Acta Paediatr Scand, (345 SUPPL.), pp. 1-100Nelson, K.B., Ellenberg, J.H., Antecedents of cerebral palsy: Multivariate analysis of risk (1986) N Engl J Med, 315, pp. 81-86Blair, E., Stanley, F.J., Intrapartum asphyxia: A rare cause of cerebral palsy (1988) J Pediatr, 112, pp. 515-519Barkovich, A.J., Destructive brain disorders of childhood (1995) Pediatric Neuroimaging. 2.ed., pp. 107-175. , Barkovich AJ. 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