Computed tomography findings in cerebral palsy in Yaound© â? Cameroon

Résumé

ABSTRACT:

Background: Cerebral palsy is a neuro-developmental condition beginning in early childhood and persisting throughout life. It is the leading cause of childhood disability affecting function and development. Neuro-imaging, with magnetic resonance imaging being the chief cornerstone, plays a vital role in determining the presence and extent of brain injury, with the possibility of determining the age of the lesions, the prognosis and also depicting concurrent or other mimicking lesions.

Aim: To determine and describe common brain lesions of cerebral palsy patients on CT in Yaound© (Cameroon) where magnetic resonance imaging is still not widely available and accessible. 

Materials and methods:     It was a cross-sectional descriptive study carried out at the Radiology and Pediatric units of a university-affiliated hospital in Yaounde. Consecutive and complete records of all patients with a clinical diagnosis of cerebral palsy who had a head CT scan performed between September 2009 and February 2012 were reviewed.                                                                        Results: One hundred and twenty patientsâ records were reviewed for the study, of which there were 66 females (sex-ratio 0.8). The mean age of the study population was 42 months with 77.4% aged 0 to 60 months. The most frequent associated clinical signs were language impairment (45.6%), mental retardation (40.2%) and epilepsy (37.8%). Spastic quadriplegia was the most frequent (26.67%) clinical subtype followed by spastic hemiplegia (15.83%). CT findings were observed in 90 percent of all the scans performed. Diffuse brain atrophy (52.7%) and cerebral hypodensities (45.4%) were the most frequent imaging findings. Atrophy was mostly cortical and sub-cortical (49.1%) while hypodensities affected the middle cerebral artery territory in 55.1% of cases. Parenchymal calcifications were seen in 11 cases (10.2%) of which two cases of confirmed CMV infections. Brain malformations were founded in eighth patients.                    

Conclusion:. Spastic quadriplegia and infantile cerebral hemiplegia were the most frequent cerebral palsy types. Diffuse brain atrophy, and parenchymal hypodense areas constitute frequent CT findings in patients with CP.

Keywords: Cerebral palsy, Computed tomography, Diffuse brain atrophy, Cerebral hypodensities, Spastic quadriplegia, Infantile cerebral hemiplegia, Cameroon.

RSUM :

Objectif. En lâabsence dâIRM, d©crire au scanner les principales anomalies c©r©brales dans une population dâenfants atteints de paralysie c©r©brale   lâH´pital Gyn©co-Obst©trique et P©diatrique de Yaound© (Cameroun). 

Mat©riel et m©thodes.  tude transversale descriptive incluant tous les enfants avec un diagnostic clinique de paralysie c©r©brale et ayant effectu© un scanner c©r©bral entre septembre 2009 et f©vrier 2012  HGOPY. 

R©sultats. Cent-vingt enfants ©taient inclus dont 66 filles. L'¢ge moyen ©tait de 42 mois avec77,4% dâenfants ¢g©s de 0   5ans. Les troubles de langage (45,6%), le retard mental (40,2%) et lâ©pilepsie (37,8%) ©taient les principaux signes cliniques associ©s. La t©trapar©sie spastique ©tait la forme la plus fr©quente (26,67%) suivie de lâh©mipl©gie c©r©brale infantile (15,83%). Le scanner ©tait pathologique dans 108cas (90%). Lâatrophie c©r©brale (52,7%) et les hypodensit©s parenchymateuses (45,4%) ©taient les anomalies les plus fr©quentes. Lâatrophie ©tait   pr©dominance cortico-sous-corticale (49,1%) alors que les hypodensit©s int©ressaient le territoire de lâart¨re c©r©brale moyenne dans 55,1%. Les calcifications parenchymateuses ©taient observ©es dans 11 cas (9,1%) dont deux cas confirm©s dâinfection   CMV. Les malformations ©taient associ©es dans huit cas (6,6%). 

Conclusion. La t©trapar©sie spastique et lâh©mipl©gie c©r©brale infantile ©taient les formes de paralysie c©r©brale les plus fr©quentes. Lâatrophie c©r©brale diffuse et les hypodensit©s constituaient les principales anomalies scanographiques.  

Mots-cl©s: Paralysie c©r©brale, Scanner, Hypodensit©s c©r©brales, T©trapar©sie spastique, H©mipl©gie c©r©brale infantile, Cameroun.

Cerebral palsy, Computed tomography, Diffuse brain atrophy, Cerebral hypodensities, Spastic quadriplegia, Infantile cerebral hemiplegia, Cameroon