Cranial MR characteristics of Cerebral Palsy cases and correlation of findings with clinical results

Abstract

The aim of this study was to compare cranial Magnetic Resonance (MR)imaging findings in cerebral palsy (CP) patients with clinical findings andevaluate damage ascribed to prenatal, natal and postnatal reasons by preterm,term or postterm characteristics.One thousand, one hundred CP patients registered at Dr. Ayten Bozkaya StateHospital of Cerebral Palsy Children and Rehabilitation Center from 2007 to2010 were included in the study retrospectively. Cranial MR images studied inBursa State Hospital Radiology Unit were evaluated by “a single senior MRIradiologist”.The most common abnormality was cerebral atrophy (80.2%) followed byperiventricular leukomalacia (PVL) (49.9%). The most common type wasspastic tetraplegia (67.9%), and the second most common type was hypotonicCP (15.6%). The percentage of congenital central nervous system (CNS)abnormality was 14.09%. The most common abnormality was corpus callosum(CC) agenesis and colpocephaly (2.3%). The least common conditions werecortical dysplasia, heterotopia and rhombencephalosynapsis. The percentageof cases born to consanguineous parents was 19.2%. In Hypoxic IschemicEncephalopathy (HIE) patients born to consanguineous parents, PVL was cysticand moderate. Consanguineous marriage was statistically significant in thepatients with cortical dysplasia and heterotopia (p<0.04), delay in myelination(p<0.001) and thalamus involvement (p< 0.008). Consanguineous marriagewas also statistically significant in spastic diparetic (p<0.017), hypotonic(p<0.001) and bedridden patients (p< 0.006). The presence of both congenitalCNS anomaly and PVL was only revealed in spastic tetraparetic type. Twentynine% of the cases were premature, while 66.4% were term children. Lowbirth weight (32.7%) constituted a risk factor for all clinical types, exceptmixed type CP. The percentage of patients with natal causes only was 21.5%.Kernicterus, cerebrovascular causes and HIE accounted for 6.3%, 2.9% and54.4% of the cases, respectively.This study may indicate the importance of consanguineous marriage, natal andpostnatal care properties as the underlying causes of CP beyond the clinicalmanagement related to delivery and allow us to identify strategies for possiblemeasures.