Hemiparetic cerebral palsy: etiological risk factors and neuroimaging

Piovesana, Ana María Sedrez Gonzaga; Moura-Ribeiro, Maria Valeriana Leme de; Zanardi, Verônica A.; Gonçalves, Vanda Maria Gimenes

doi:10.1590/s0004-282x2001000100007

Cited by 16 publications

(19 citation statements)

References 19 publications

(28 reference statements)

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“…Great progress has been made in relation to imaging in HCP, only 8% to 24% of the examinations being reported as normal 2,4 of positive findings has been reported in the literature [5][6][7][8][9] . For parents seeking a cause for their child's disability, a radiological diagnosis is now possible in the majority of cases.…”

Section: Discussionmentioning

confidence: 99%

“…For parents seeking a cause for their child's disability, a radiological diagnosis is now possible in the majority of cases. Recent studies, based on neuroimaging findings, provide objective information, elucidating and classifying the etiology of CP more clearly 2,10 . The pattern of brain injury of patients with CP is closely related to the gestational age of occurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last few decades, prenatal etiology has been confirmed based on neuropathological studies and more recently using MRI 2,4,19,20 . Steinlin et al analysed the MRI findings of 33 children with congenital hemiplegia and their data suggested a prenatal origin in 20 to 40% of cases 6 .…”

Section: A High Ratementioning

confidence: 99%

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MRI Findings in Patients with Hemiparetic Cerebral Palsy

et al. 2006

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Given the more severe and extensive unilateral brain abnormalities in hemiparetic cerebral palsy (HCP) patients than in other spastic cerebral palsy patients we focused exclusively on the localization of brain lesions in children with HCP. The relationship between neuroradiological findings and side of hemiparesis was investigated in a group of 30 children with HCP. Seventeen boys and 13 girls aged four to18 years (mean age 9.7±4.2 years) were included in this study. Computed tomography and magnetic resonance imaging examinations were correlated with the birth histories, obstetrical records and clinical summaries. Of the 30 patients with HCP, 2 (6.6%) had normal neuroradiological examinations, 20 (66.6%) had unilateral and eight (26.6%) bilateral brain lesions. A brain lesion on the contralateral side of hemiparesis was found in 93.3% of the neuroradiological examinations. The commonest neuroradiological findings in our study were periventricular leukomalacia (PVL, 80%), atrophy (70%) and porencephalic cyst (50%). There was a significant relationship between the symptomatic side and contralateral PVL, atrophy and porencephalic cyst (40%). PVL, atrophy and porencephalic cyst were significantly concomitant on the same side (46.6%). We demonstrated for the first time in the literature that PVL, atrophy and porencephaly are usually observed concomitantly and contralateral to the side of motor impairement in HCP patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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MRI Findings in Patients with Hemiparetic Cerebral Palsy

et al. 2006

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“…Hemiparetic cerebral palsy, i.e. paralysis of one complete side of the body including the arm, trunk and leg, is one of the most common types of cerebral palsy referred to in the literature and is classified as a subdivision of spastic cerebral palsy 8 .…”

Section: Introductionmentioning

confidence: 99%

Hemiparetic cerebral palsy: clinical data compared with neuroimaging

Souza¹,

Ciasca²,

Moura-Ribeiro³

et al. 2006

Rev. bras. fisioter.

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Objective: The present study correlated fine motor function (FMF) and sensory function (SF) performance with magnetic resonance imaging classification, in cases of hemiparetic cerebral palsy. Method: Specific protocols were used to evaluate FMF, SF and brain lesion extent and location in the hemisphere. Forty-six patients were assessed: 23 with hemiparetic cerebral palsy (group 1) and 23 normal individuals (group 2). Their ages ranged from 7 to 16 years, with a mean of 12 years and 8 months. Results: FMF and SF performance in group 1 was significantly worse than in group 2. Hemiparetic cerebral palsy cases with lesions in only one brain structure presented better results than those with two or more damaged structures larger than 10 mm. Patients with unilateral or bilateral cortical and subcortical impairment presented worse performance than those with subcortical lesions. Conclusion: Motor and sensory dysfunctions need to be identified and understood in order to provide routine training and special care for such children.Key words:cerebral palsy, neuroimaging, fine motor function, sensory function. RESUMO Paralisia Cerebral Hemiparética: Dados Clínicos Comparados à NeuroimagemObjetivo: Este estudo correlacionou o desempenho da função motora fina (FMF) e Sensorial (FS) na paralisia cerebral hemiparética (PC-H) à classificação da ressonância magnética (RM). Método: Utilizaram-se os protocolos específicos para avaliar FMF, FS e lesões encefálicas quanto à sua extensão e localização no hemisfério. Foram avaliados 46 sujeitos sendo 23 com PC-H, grupo 1, e 23 crianças normais, grupo 2. A idade variou entre 07 a 16 anos, idade média de 12 anos e 8 meses. Resultados: O desempenho das FMF e FS demonstrou ser significantemente pior no grupo 1 quando comparado ao grupo controle. PC-H que apresentavam lesões atingindo uma única estrutura encefálica demonstraram melhores resultados que aqueles com comprometimento atingindo duas estruturas maiores que 10 mm. O desempenho dos sujeitos com comprometimento cortical e subcortical, uni ou bilateral, foi inferior quando comparados aos com lesões subcorticais. Conclusão: As disfunções motoras e sensoriais necessitam ser identificadas e compreendidas para prover melhor treinamento de rotina e cuidados especiais a essas crianças.Palavras-chave: paralisia cerebral, neuroimagem, teste de movimentos finos e de sensibilidade. 158Turolla de Souza RC, Ciasca SM, Moura-Ribeiro MVL, Zanardi VA Rev. bras. fisioter.

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“…Estudos recentes valorizam a importância da neuroimagem associada à avaliação clinica e ao prognós-tico da PC [5][6][7] . Porém, não encontramos pesquisas relacionando as lesões cerebrais e o tono muscular.…”

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Estudo comparativo do tono muscular na paralisia cerebral tetraparética em crianças com lesões predominantemente corticais ou subcorticais na tomografia computadorizada de crânio

Iwabe

Piovesana

2003

Arq. Neuro-Psiquiatr.

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RESUMO-Objetivo: Comparar a distribuição e intensidade do tono muscular na paralisia cerebral tetraparética espástica (PC-T), correlacionando os dados clínicos com a localização da lesão no sistema nervoso central. Método: Foram incluídas 12 crianças de dois a quatro anos de idade com lesões predominantemente corticais (seis crianças) e subcorticais (seis crianças). O tono foi analisado nos membros superiores (MMSS) e inferiores (MMII) baseado no protocolo de Durigon e Piemonte. Resultados: Não houve diferença significante quanto à intensidade e distribuição de tono em MMSS e MMII nos dois grupos. Comparando os MMSS e MMII de sujeitos do mesmo grupo, os MMII apresentaram mais assimetrias e maior intensidade do tono do que os MMSS. Conclusão: Neste estudo, crianças com PC devido a lesões predominantemente corticais ou subcorticais apresentam déficit semelhante na modulação de tono, ocasionando distribuição simétrica e homogênea de hipertonia que predomina em MMII. PALAVRAS-CHAVE: paralisia cerebral, tono muscular, sistema nervoso central. Comparative study of muscular tonus in spastic tetraparetic cerebral palsy in children with predominantly cortical and subcortical lesions in computerized tomography of the skull ABSTRACT-Objective: To compare distribution and intensity of muscular tonus in spastic tetraparetic cerebral palsy (CP), correlating the clinical data with lesion location in the central nervous system. Method: Twelve children aged two to four years old with predominantly cortical lesions (six children) and subcortical lesions (six children) were included. The tonus was analyzed in the upper (UULL) and lower limbs (LLLL) based on Durigon and Piemonte protocol. Result: There was no significant difference regarding tonus intensity and distribution in the UULL and LLLL in both groups. Comparing the upper and lower limbs of subjects in the same group, the LLLL presented more asymmetry and higher tonus intensity than the UULL. Conclusion: In this study children with CP as a result of predominantly cortical or subcortical lesions present a similar deficit in tonus modulation, causing a symmetric and homogeneous distribution of hypertonicity, which is predominant in the LLLL.

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Hemiparetic cerebral palsy: etiological risk factors and neuroimaging

Cited by 16 publications

References 19 publications

MRI Findings in Patients with Hemiparetic Cerebral Palsy

MRI Findings in Patients with Hemiparetic Cerebral Palsy

Hemiparetic cerebral palsy: clinical data compared with neuroimaging

Estudo comparativo do tono muscular na paralisia cerebral tetraparética em crianças com lesões predominantemente corticais ou subcorticais na tomografia computadorizada de crânio

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