engleski

Long-term neurodevelopmantal and neuroimaging follow-up of 21 children with cerebral palsy

Out of 137 high-risk neonates (81 preterms and 56 terms), hypoxic-ischemic and/or hemorrhagic perinatal brain lesions were detected by ultrasonography in 94, whereas in 43 ultrasound findings were normal. At the age of 2 years, 26 children had spastic CP (6 tetraparesis, 3 triparesis, 4 hemiparesis and 8 dyplegia), accompanied in 6 children with one or multiple severe impairments (mental retardation, epilepsy, blindness). All the children with CP had perinatal brain lesions (17 extensive intraventricular haemorrhage, accompanied in 11 by periventricular/subcortical leukomalacia, 4 isolated periventricular/subcortical leukomalacia). none of the children with normal ultrasound finding had CP. Late ultrasonography showed in all the children with CP moderate or severe ventriculomegaly, accompanied in 12 children with subcortical atrophy and/or posthaemorrhagic and/or postleukomalacic destructive lesions. Physiotheraphy was performed in all the children from early infancy onwards (optimally in 12, less optimally in5 and insufficiently in 4), whereas 8 children underwent orthopedic surgery. At neurological reassessment at the age of 13-15 years, 18 children were still considered as having CP, whereas in 3 children neuromotor impairment improved to minimal neuromotor dysfunction. In 7 children extrapyramidal signs occurred, 5 have less severe and/or extensive CP. All the children with CP had mild or severe visual disorders, 10 had epilepsy and 8 were moderately or severely mentally retarded. High resolution MRI demonstrated in 14 children ventriculomegally and in all the children with CP variety of white matter abnormalities (destructive lesions, dysmyelinisation, thin and/or irregular corpus callosum), in 7 children additionally grey matter abnormalities (reduced basal ganglia, cortical atrophy and/or dysgenesis).

cerebral palsy; long term follow-up; neurodevelopmental outcome; neuroimaging

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