J Korean Acad Rehabil Med.  2002 Oct;26(5):508-513.

The Estimation of the Probable Cause and the Time of Cerebral Insult in Cerebral Palsy

Affiliations
  • 1Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea. JLMOON@catholic.ac.kr
  • 2Department of Radiology, College of Medicine, The Catholic University of Korea.
  • 3Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Korea.

Abstract


OBJECTIVE
To estimate the probable cause and the time of cerebral insult in cerebral palsy (CP) based on MRI findings and risk factors. METHOD: The subjects comprised all sixty-seven patients with CP showing abnormal MRI findings between March 1999 and September 2001 at the Catholic University of Korea, St. Mary's Hospital. A detailed medical history was available for all patients including those not born in our hospital. They ranged in age from two months to five years. We analyzed the brain magnetic resonance (MR) findings of patients with CP to correlate the probable cause and the time of cerebral insult through the consideration of medical histories including prenatal, perinatal and postnatal histories.
RESULTS
Of the 67 MRIs, abnormalities were the followings; periventricular leukomalacias (PVLs) in 49 cases, cortical or subcortical infarction in 4 cases, brain atrophy in 7 cases, neuronal migration disorder in 4 cases, and delayed myelination in 3 cases. Among the patients with PVL, perinatal risk factors were responsible for cerebral insult in preterm, but pre- and perinatal contribution were similar in patients born at full term. Among the patients with cerebral infarction, only one case with meningitis at 11 months was suspected for cerebral insult. These patients had no risk factor as a peri- or post-natal etiology. Four patients with neuronal migration disorder had no risk factor for peri- or postnatal etiology except for the one who was a twin.
CONCLUSION
Review of brain MRI findings such as PVL, infarct, neuronal migration disorder and a detailed medical history including prenatal and perinatal etiology would be a useful method to estimate the probable cause and the time of cerebral insult in CP.

Keyword

Cause; Cerebral palsy; Brain MRI; Cerebral insult; Risk factor
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