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痉挛型脑瘫患儿先天性脑畸形的临床及神经影像学特征

Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy.

作者信息

Kułak W, Sobaniec W, Gościk M, Oleński J, Okurowska-Zawada B

机构信息

Department of Pediatric Rehabilitation, Medical University of Bialystok, Bialystok, Poland.

出版信息

Adv Med Sci. 2008;53(1):42-8. doi: 10.2478/v10039-008-0006-z.

Abstract

PURPOSE

Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital-based study.

MATERIAL AND METHODS

The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP.

RESULTS

Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm.

CONCLUSIONS

Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP.

摘要

目的

在一项基于医院的研究中分析痉挛型脑瘫(CP)患儿先天性脑畸形的发生率。

材料与方法

本研究纳入了74名男孩和56名女孩,他们患有痉挛性四肢瘫、双瘫和偏瘫型CP。对CP患儿的磁共振成像(MRI)结果进行分析。

结果

124名(95.3%)受试者的MRI显示出与CP相关的显著异常。痉挛性双瘫患儿中脑室周围白质软化(PVL)的检出率高于四肢瘫或偏瘫患儿。与双瘫患者相比,四肢瘫组中脑萎缩更为常见。痉挛性偏瘫患儿中孔洞脑囊肿的检出率更高。15名(10.7%)痉挛型CP患儿存在先天性脑异常。脑畸形包括:脑裂畸形(5例)、胼胝体发育不全(4例)、多小脑回(2例)、前脑无裂畸形(2例)和无脑回畸形(2例)。脑异常患儿中难治性癫痫和智力障碍更为常见。12例先天性脑畸形患儿为足月儿出生,3例为早产儿出生。

结论

CP患儿的神经影像学结果可能有助于确定病因并更好地预测CP的预后。

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