Authors
1 Department of Surgery, Medical Collage, Kirkuk University
2 Department of Radiology, Azadi Teaching Hospital, Kirkuk
Abstract
dnuorgkcaB: Cerebral palsy (CP) is a major cause of the disability in children. It is considered a neurological disease occurs due to a non-progressive brain injury or anomaly that occurs while the brain is developing. Intracranial imaging provides a window to see the brain lesion and potentially, provide an insight into the pathogenesis of CP. Objectives: To reveal the radiological changes of brain using CT scan in different clinical types of CP and in those CP children with functional impairments. Material and methods: Sixty eight children with previous diagnosis of cerebral palsy were scanned with computed tomography (Philips, brilliance 64) for brain without contrast at Azadi Teaching Hospital/Kirkuk city, from February 2013 to July 2016. Clinical information was obtained from the documentation of pediatricians. The images were reviewed by two board certificate radiologists with at least 6 years of experience. Result: Sixty-eight patients were included in the study, 42(61.8%) females and 26(38.2%) males with female to male ratio 1.6:1and an overall mean age at presentation was 12 months. Most (79.3%) children with cerebral palsy had abnormal neuro-radiological findings, Diffuse brain atrophy predominantly involving the cortical –subcortical grey matter with and without white matter hypodensities which indicate grey matter injury (35.4%) was the most common finding and it was more in the pyramidal CP (100%), followed by white matter atrophy and hyposensitizes with or without ventriculomegaly indicating white matter injury in (23.5%) which was the most common CT finding in cerebellar CP (50%), congenital malformations found in (8.8%) including pachygyria, and Dandy-Walker malformation, entirely seen in quadriplegic type, focal vascular brain insult seen in (5.9%) occurred only in diplegic type, and the least was ventriculomegaly labeled as miscellaneous (2.9%) occurred only in quadriplegic CP. CT scan was normal in (20.7%), predominantly in cerebellar type. There were significantly more patients with abnormal CT findings among CP children suffering from convulsion (p>0.05) than those without convulsion, this was not true in those with microcephaly (p<0.05). Conclusion: CT scan brain is a good modality for detection of structural brain abnormality in cerebral palsy (CP) cases. There was significant correlation between the topographic distribution of motor deficit and brain CT findings. There were significantly more patients with abnormal CT findings among CP children suffering from convulsion but not microcephaly
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