PATHOGENESIS, NEUROIMAGING AND MANAGEMENT IN CHILDREN WITH CEREBRAL PALSY BORN PRETERM

被引:11
作者
Hoon, Alexander H., Jr. [1 ]
Faria, Andreia Vasconcellos [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Phelps Ctr Cerebral Palsy & Neurodev Med, Kennedy Krieger Inst, Baltimore, MD 21205 USA
关键词
apparent diffusion coefficient; diffusion tensor imaging; diffusion weighted imaging; fractional anisotropy; functional connectivity MRI; hypoxic-ischemic encephalopathy; intraventricular hemorrhage; large deformation diffeomorphic metric mapping; magnetic resonance imaging (conventional); magnetic resonance spectroscopy; neonatal intensive care unit; periventricular leukomalacia; small for gestational age; very low birth weight; white matter; INTRATHECAL BACLOFEN INFUSION; SELECTIVE DORSAL RHIZOTOMY; WHITE-MATTER INJURY; PERIVENTRICULAR LEUKOMALACIA; NEURODEVELOPMENTAL OUTCOMES; FUNCTIONAL CONNECTIVITY; CRANIAL ULTRASOUND; GESTATIONAL-AGE; BRAIN-INJURY; TERM;
D O I
10.1002/ddrr.127
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
With advances in obstetric and perinatal management, the incidence of intraventricular hemorrhage in premature infants has declined, while periventricular leukomalacia remains a significant concern. It is now known that brain injury in children born preterm also involves neuronal-axonal disease in supratentorial and infratentorial structures. The developing brain is especially vulnerable to white matter (WM) injury from 23 to 34 weeks gestation when blood vessels serving the periventricular WM are immature. Oligodendrocyte progenitors, which are beginning to form myelin during this time, are susceptible to attack from oxygen free radicals, glutamate, and inflammatory cytokines. Advances in imaging techniques such as diffusion tensor imaging provide a more complete picture of the location and extent of injury. Effective management of children born preterm with cerebral palsy is predicated on an understanding of sequential links from etiological antecedents to brain neuropathology as revealed with neuroimaging techniques to clinical phenotypes, toward focused interventions with measurable outcomes. (C) 2011 Wiley Periodicals, Inc. Dev Disabil Res Rev 2010;16:302-312.
引用
收藏
页码:302 / 312
页数:11
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