Open AccessPathogenesis, neuroimaging and management in children with cerebral palsy born preterm
Author(s) -
Hoon Alexander H.,
Vasconcellos Faria Andreia
Publication year - 2010
Publication title -
developmental disabilities research reviews
Language(s) - English
Resource type - Journals
eISSN - 1940-5529
pISSN - 1940-5510
DOI - 10.1002/ddrr.127
Subject(s) - periventricular leukomalacia , medicine , neuroimaging , intraventricular hemorrhage , cerebral palsy , neuropathology , white matter , pediatrics , pathology , diffusion mri , magnetic resonance imaging , neuroscience , psychology , disease , gestational age , radiology , psychiatry , pregnancy , genetics , biology
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. © 2011 Wiley Periodicals, Inc. Dev Disabil Res Rev 2010;16:302–312.