Menkes J H, Curran J
Division of Pediatric Neurology, University of California, Los Angeles 90024-1721.
AJNR Am J Neuroradiol. 1994 Mar;15(3):451-7.
To identify the characteristic MR findings in extrapyramidal cerebral palsy.
Six patients who had suffered intrapartum asphyxia and who subsequently developed extrapyramidal cerebral palsy were identified. Asphyxia was evidenced by severe neonatal systemic acidosis as documented by a venous cord pH of less than 7.0 whenever available, or acidosis in subsequent arterial blood gas samples, and clinical signs of an acute hypoxic-ischemic encephalopathy during the neonatal period. In addition, 1- and 5-minute Apgar scores were 3 or less, and there had been need for intubation or vigorous resuscitation in the delivery room. There were three boys and three girls, all born at term, with birth weight appropriate for gestational age, and without a history of bilirubin levels above 15 mg/dL. MR imaging at 1.5 T was performed between 1 and 19 years of age.
In all subjects focal high signal abnormality was demonstrated in the posterior putamen and the anterior or posterior thalamus. There were no other findings in most cases.
MR demonstrated lesions in the putamen and thalamus in all of our six patients with severe extrapyramidal cerebral palsy who had suffered intrapartum asphyxia.
确定锥体外系型脑瘫的特征性磁共振成像（MR）表现。
确定6例有产时窒息且随后发生锥体外系型脑瘫的患者。若有记录，脐静脉血pH值小于7.0时出现的严重新生儿全身酸中毒，或随后动脉血气样本中的酸中毒，以及新生儿期急性缺氧缺血性脑病的临床体征，均可证明存在窒息。此外，1分钟和5分钟阿氏评分均为3分或更低，且在产房需要插管或积极复苏。有3名男孩和3名女孩，均为足月儿，出生体重与孕周相符，且无胆红素水平高于15mg/dL的病史。在1至19岁之间进行了1.5T的MR成像检查。
所有受试者的壳核后部以及丘脑前部或后部均显示局灶性高信号异常。大多数情况下无其他发现。
在我们6例患有严重锥体外系型脑瘫且有产时窒息的患者中，MR均显示壳核和丘脑有病变。
