Bilateral Spastic Cerebral Palsy - Pathogenetic Aspects from MRI

Krägeloh-Mann, I.; Hagberg, B; Petersen, Dirk; Riethmüller, Joachim; Gut, E.; Michaelis, Richard

doi:10.1055/s-2008-1071311

Cited by 63 publications

(25 citation statements)

References 6 publications

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“…The MRI data obtained in this group of infants with cerebral palsy following a neonatal ultrasound diagnosis of periventricular leukomalacia are in agreement with many other Linda S. de Vries et al reports, available in the literature (3,15,16,19,20,21,24,26). Furthermore, there appeared to be a good correlation between the degree of periventricular leukomalacia, diagnosed using cranial ultrasound, and the extent of MRI changes later in infancy.…”

Section: Discussionsupporting

confidence: 92%

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Correlation between the Degree of Periventricular Leukomalacia Diagnosed Using Cranial Ultrasound and MRI Later in Infancy in Children with Cerebral Palsy

et al. 1993

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During a period of 30 months, 504 infants of 34 weeks gestation or less were enrolled in a prospective cranial ultrasound study. Ninety-two (18.4%) infants developed different degrees of periventricular leukomalacia (PVL), being transient periventricular echogenicities (PVE) in 75, localised cystic lesions in 7 and extensive cysts in 10. Eight of 75 (10.6%) infants with PVE, 4 of the 6 (66.6%) survivors with localised cysts and all 8 survivors with extensive cysts developed cerebral palsy in infancy and MRI studies could be performed in 15 of these 20 infants between 11 and 32 months of age. Neurological sequelae were most severe among the infants with extensive cysts and none were able to walk, while 6 of the 12 who developed cerebral palsy following either PVE or localised cysts had learned to walk independently. There appeared to be a good correlation between the degree of PVL, diagnosed using ultrasound, and the extent of MRI changes noted in infancy. Ventricular enlargement and delay in myelination were more common in infants with cystic lesions and periventricular hyperintensity (PVHI) was present in all infants, but most extensive in the cases with extensive cysts. MRI performed later in infancy may, even in the absence of neonatal cranial ultrasound, provide information about both the presence as well as the degree of leukomalacia, which the child may have suffered in the neonatal or antenatal period.

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Section: Discussionsupporting

confidence: 92%

“…In some reports the infants were selected on the basis of the development of spastic diplegia (16,19,20,24,28), while in other studies earlyimaging, usually cranial ultrasound, had shown the development of extensive cystic periventricular leukomalacia (3,6,9,13).…”

Section: Introductionmentioning

confidence: 99%

Correlation between the Degree of Periventricular Leukomalacia Diagnosed Using Cranial Ultrasound and MRI Later in Infancy in Children with Cerebral Palsy

et al. 1993

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“…Periventricular leucomalacia, which has recently been associated with maternal chorio-amnionitis [19], is a strong predictor of cerebral palsy of the spastic diplegia type, in LBW survivors [11]. Neonatal events such as sepsis and seizures may be associated with an increased risk of``new morbidities'' [15,33] but the search for reliable risk factors for the majority of cases has been disappointing [18].…”

Section: Aetiology Of``new Morbidities''mentioning

confidence: 99%

Long-term outcome for non-handicapped low birth weight infants – is the fog clearing?

Sommerfelt

1998

Eur J Pediatr

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The frequency of cerebral palsy increases with decreasing gestational age affecting approximately 7% of survivors with birth weights less than 1500 g (very low birth weight, VLBW) [7]. In addition, low birth weight (birth weight less than 2500 g, LBW) and VLBW children without cerebral palsy or other major neurohandicaps have an increased frequency of "new morbidities" including learning disabilities, behavioural problems, lower mean IQ, and motor clumsiness compared to normal birth weight peers [15, 16, 20]. However, understanding is still lacking regarding the nature and frequency of such problems, predisposing risk factors, and the relationship of such problems with parental factors, including socio-economic status. A fundamental concept for understanding the large and often confusing literature on LBW and later neurobehavioral development is that LBW may have many different aetiologies, with varying relative frequency in different populations, which probably have different degrees of associated risk for impairment of later development.

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“…This information is also necessary for appropriate genetic and medicolegal counseling of the parents. Magnetic resonance (MR) imaging studies, by identifying specific patterns of damage or malformation, are often able to determine the etiology of the motor dysfunction and the approximate timing of the insult [Truwit et al, 1992;Krageloh-Mann et al, 1992]. The severity and extent of damage can also be evaluated with MR studies.…”

mentioning

confidence: 99%