CP etiology Flashcards
definition of CP
a group of permanent disorders of the development of MOVEMENT AND POSTURE causing activity limitation, that are attributed to NONPROGRESSIVE disturbances that occurred in the DEVELOPING FETAL OR INFANT BRAIN
prevalance of CP
about 2-3 children out of every 1,000 will be diagnosed with CP
most common childhood motor disability
key points for definition of CP
non progressive lesion
developing brain
disorder of posture and movement (accompanied by other problems)
prenatal risk factos
genetics
infections (TORCH)
placental complications
prematurity
perinatal risk factos
infections (TORCH)
birth complications resulting in lack of ocygen
postnatal
head trauma
near drowning
strokes
meningitis
TORCH
toxoplasmosis
other
rubella
cytomegalovirus
herpes simplex virus
CP pathogenesis - peiventricular leukomalacia (PVL)
most common cause
leads to hemorrhagic or ischemic injuries
damage to white matter of the brain from lack of blood flow
more sensitive to injury between 26 and 34 weeks of pregnancy
CP pathogenesis - brain hemorrhage
intraventricular or periventricular hemorrhage
most occur within the first 48 hours after birth
more focal - specific blood vessels and area of brain
CP Pathogenesis - lock of oxygen
hypoxic-ischemic-encephalopathy (HIE)
- damage to whole brain
symptoms typically evolve over a period of 72 hrs after birth
more diffuse - damage to the whole brain
CP Pathogenesis - Brain Malformation
infections, fever, trauma, or gene mutations can cause the brain to develop abnormally
drug exposure, radiation, viruses
may cause hemorrhagic or ischemic injuries
grade 1 intraventricular hemorrhage (IVH)
isolated to the germinal matrix
grade 2 intraventricular hemorrhage (IVH)
bleeding occurs in ventricles, ventricles maintain normal size
grade 3 intraventricular hemorrhage (IVH)
when bleeding occurs in ventricles, ventricles maintain normal size
volume of blood has caused ventricles to expand
grade 4 intraventricular hemorrhage (IVH)
when hemorrhage spreads into the periventricular white matter
necrosis that really causes difficulty neurologically
unilateral problems presents like someone who had a stroke
hypoxic ischemic encephalopathy (HIE) risk factors
lack of oxygen to the whole system
- maternal hypotension/hypertension
- placental/uterus complications
- injury from the umbilical cord
- fetal heart problems
- trauma
- fetal infections
key takeaways
nonprogressive lesion, immature brain, and disorder of posture and movement
periventricular white matter is very susceptible to hemorrhagic or ischemic lesion
severity and topography of CP is related to time of injury, the degree of injury, and the cause of injury/damage
diagnosing CP based on combined findings from the neurological assessment, neuroimaging, and assessment of posture and movement
some CP children have normal MRI T or F
T
motor tracks closest to the ventricles are for the legs so if bleed is smaller what is involved
leg and trunk
for larger bleed more parts would be involved
