Kotlarek F, Rodewig R, Brüll D, Zeumer H
Neuropediatrics. 1981 May;12(2):101-9. doi: 10.1055/s-2008-1059643.
40, 1-14-year-old children suffering from congenital hemiparesis were re-examined neurologically and admitted to CT. According to our morphological results we found three different types of CT patterns: 1. unilateral enlargement of the lateral ventricle or parts of it (20 patients), 2. cavity in the cortex and subcortical white matter within the supply area of the middle cerebral artery (17 patients), 3. normal CT scans (3 patients). Patients with a cortical and subcortical cavity consistently had a moderate to severe hemiparesis and suffered more often from epilepsy and intellectual impairment than patients with unilateral ventricular enlargement and those with normal CT findings. Most patients with cortical defects had a history of perinatal complications, while abnormal pregnancies and prematurity prevailed in patients with unilateral ventricular enlargement. We believe that a cavity in the cortex and subcortical white matter is of arterial-ischemic origin, whereas unilateral ventricular enlargement with destruction of the deep white matter is related to venous hemorrhage. But it must be emphasized that CT cannot detect the causes, mechanisms and timing of the underlying brain lesions in congenital hemiparesis.
40名1至14岁患有先天性偏瘫的儿童接受了神经学复查并进行了CT检查。根据我们的形态学结果，我们发现了三种不同类型的CT模式：1. 侧脑室或其部分单侧扩大（20例患者），2. 大脑中动脉供血区内皮质和皮质下白质出现空洞（17例患者），3. CT扫描正常（3例患者）。与单侧脑室扩大和CT检查正常的患者相比，皮质和皮质下有空洞的患者始终存在中度至重度偏瘫，且更常患有癫痫和智力障碍。大多数有皮质缺损的患者有围产期并发症史，而单侧脑室扩大的患者中异常妊娠和早产更为常见。我们认为，皮质和皮质下白质中的空洞起源于动脉缺血，而伴有深部白质破坏的单侧脑室扩大与静脉出血有关。但必须强调的是，CT无法检测出先天性偏瘫潜在脑损伤的病因、机制和发生时间。
