NeuroPathology - Lecture 13 - Cerebral Palsy Flashcards
What is cerebral palsy?
a non-progressive, permanent disorder of posture and movement
What determines the type of cerebral palsy?
which part of the brain is affected; cerebral cortex, basal ganglia, cerebellum
How does cerebral palsy present when the cerebral cortex is affected?
stiff muscles/spasticity
How does cerebral palsy present when the basal ganglia is affected?
uncontrollable movements (dyskinesia)
How does cerebral palsy present when the cerebellum is affected?
poor balance and coordination
How does cerebral palsy present when multiple areas of the brain are affected?
mixed or a combination of two or more types of cerebral palsy
Spastic Cerebral Palsy presents as…
stiff muscles in legs and/or arms on one or both sides of the body
Dyskinetic Cerebral Palsy presents as…
slow, uncontrollable jerky movement, hyperactivity in face/tongue
Ataxic Cerebral Palsy presents as…
balance and depth perception is off, poor coordination, unsteady gait, wide BOS, difficulty with precise movements
Mixed Cerebral Palsy presents as…
Combination of other types of cerebral palsy
What is the neuropathology of Cerebral Palsy?
damage to white matter of the brain, abnormal development of the brain, bleeding in the brain, lack of oxygen
What is the incidence of Cerebral Palsy - Prenatal?
structural abnormality, neonatal stroke, severe infection
What is the incidence of Cerebral Palsy - Perinatal?
low birth weight, peri-ventricular leukomalacia, intraventricular hemorrhage, hypoxic-ishcemic encephalopathy, untreated jaundice
What is the incidence of Cerebral Palsy - Postnatal?
Injuries (shaken baby syndrome), trauma, infections, stroke
What are common causes of Cerebral Palsy?
Periventricular Leukomalacia
Intraventricular Hemorrhage
Hypoxic-Ischemic Encephalopathy
What is the pathogenesis for PVL?
infants are at higher risk of ischemia in PV areas, especially between 23- 32 weeks’ gestation
What is the pathway of CSF in the ventricles?
Lateral ventricles –> foramen of monro –> third ventricle –> cerebral aqueduct –> fourth ventricle –> foramen of Luschka and foramen of Magendie
What is the pathogenesis for IVH?
caused by disruption of fragile vascular network of germinal matrix and subsequent ventricular dilatation, between 8-28 weeks’ gestation
What is the pathogenesis for HIE?
decreased perfusion resulting from systemic hypotension and poor autoregulation of cerebral blood flow
What is Bilirubin Encephalopathy (Kernicterus)?
Acquired metabolic encephalopathy of neonatal period // unbound and conjugated circulating bilirubin crosses the blood brain barrier
What are the clinical manifestations of Bilirubin Encephalopathy?
Changes in muscle tone // poor selective control of muscles // poor regulation of activity // decreased ability to learn unique movements // delayed postural response // inappropriate sequencing of movements
