%0 Journal Article %1 Uvebrant1988 %A Uvebrant, P. %D 1988 %J Acta Paediatr Scand Suppl %K Adolescent; Cerebral Palsy; Child; Follow-Up Studies; Hemiplegia; Humans; Prognosis; Retrospective Sweden; Tomography, X-Ray Computed %P 1--100 %T Hemiplegic cerebral palsy. Aetiology and outcome. %V 345 %X Hemiplegic cerebral palsy (CP) was studied in a retrospective population-based series of 169 cases from the South-western Swedish health care region covering the birth years 1969-78. The purpose was to analyse the prevalence, aetiology and neuro-developmental outcome in children born preterm and at term, and to correlate pathogenetic periods, aetiological factors and clinical parameters to neuroradiology. The prevalence at the ages 6-15 years was 0.66 per 1000. Postnatally acquired hemiplegia, mainly postinfectious, iatrogenic or posttraumatic, constituted 11\%. Among term children with congenital hemiplegia (pre and perinatally derived) the aetiology was considered prenatal, mainly circulatory brain lesions and maldevelopments, in 42\%, combined pre and perinatal in 9\%, perinatal (cerebral haemorrhage, hypoxia) in 16\% and untraceable in 34\%. The corresponding distribution among preterm children was 29\%, 47\%, 25\% and 6\%, respectively. The rate of preterm birth among congenital cases was 24\%. Birth asphyxia was shown to be a poor indicator of pathogenetic period, whereas a cascade of postpartum complications suggested perinatal brain damage. Clinical follow-up of 152 children revealed that 50\% had mild, 31\% moderate and 19\% severe motor dysfunction. Stereognostic sense was impaired in 44\% of the children (astereognosia in 20\%). Additional impairments (mental retardation, epilepsy, impaired vision, hearing and speech, severe behavioural/perceptual problems) were present in 42\%. Term children with congenital hemiplegia tended to be more severely affected than preterm children. The resulting total handicap was considered mild in 40\%, moderate in 44\% and severe in 16\%. The prevalence of severe total handicap was highest among postnatal cases. Computerised tomography (CT), performed in 109 congenital cases, was normal in 26\%, showed unilateral ventricular enlargement in 36\% and revealed cortical/subcortical cavities in 20\%. In the remaining 18\% CT findings were classified as öther". With the classification so far used, correlations between CT findings and aetiologies were unsatisfactory and disappointing. In contrast, CT findings showed a strong correlation with clinical degree of severity and magnitude of associated handicap. As a rule, normal CT implied mild disability and unilateral ventricular enlargement moderate, whereas cortical/subcortical cavities were frequently associated with severe handicap, including mental retardation and epilepsy.

@article{Uvebrant1988, abstract = {Hemiplegic cerebral palsy (CP) was studied in a retrospective population-based series of 169 cases from the South-western Swedish health care region covering the birth years 1969-78. The purpose was to analyse the prevalence, aetiology and neuro-developmental outcome in children born preterm and at term, and to correlate pathogenetic periods, aetiological factors and clinical parameters to neuroradiology. The prevalence at the ages 6-15 years was 0.66 per 1000. Postnatally acquired hemiplegia, mainly postinfectious, iatrogenic or posttraumatic, constituted 11\%. Among term children with congenital hemiplegia (pre and perinatally derived) the aetiology was considered prenatal, mainly circulatory brain lesions and maldevelopments, in 42\%, combined pre and perinatal in 9\%, perinatal (cerebral haemorrhage, hypoxia) in 16\% and untraceable in 34\%. The corresponding distribution among preterm children was 29\%, 47\%, 25\% and 6\%, respectively. The rate of preterm birth among congenital cases was 24\%. Birth asphyxia was shown to be a poor indicator of pathogenetic period, whereas a cascade of postpartum complications suggested perinatal brain damage. Clinical follow-up of 152 children revealed that 50\% had mild, 31\% moderate and 19\% severe motor dysfunction. Stereognostic sense was impaired in 44\% of the children (astereognosia in 20\%). Additional impairments (mental retardation, epilepsy, impaired vision, hearing and speech, severe behavioural/perceptual problems) were present in 42\%. Term children with congenital hemiplegia tended to be more severely affected than preterm children. The resulting total handicap was considered mild in 40\%, moderate in 44\% and severe in 16\%. The prevalence of severe total handicap was highest among postnatal cases. Computerised tomography (CT), performed in 109 congenital cases, was normal in 26\%, showed unilateral ventricular enlargement in 36\% and revealed cortical/subcortical cavities in 20\%. In the remaining 18\% CT findings were classified as "other". With the classification so far used, correlations between CT findings and aetiologies were unsatisfactory and disappointing. In contrast, CT findings showed a strong correlation with clinical degree of severity and magnitude of associated handicap. As a rule, normal CT implied mild disability and unilateral ventricular enlargement moderate, whereas cortical/subcortical cavities were frequently associated with severe handicap, including mental retardation and epilepsy.}, added-at = {2014-07-19T21:50:30.000+0200}, author = {Uvebrant, P.}, biburl = {https://www.bibsonomy.org/bibtex/28e952bedcd259bbaadfb1fdcf93a3ec1/ar0berts}, groups = {public}, interhash = {9953cf7f0f97d226a8da4b6ecf9521dd}, intrahash = {8e952bedcd259bbaadfb1fdcf93a3ec1}, journal = {Acta Paediatr Scand Suppl}, keywords = {Adolescent; Cerebral Palsy; Child; Follow-Up Studies; Hemiplegia; Humans; Prognosis; Retrospective Sweden; Tomography, X-Ray Computed}, pages = {1--100}, pmid = {3201989}, timestamp = {2014-07-19T21:50:30.000+0200}, title = {Hemiplegic cerebral palsy. Aetiology and outcome.}, username = {ar0berts}, volume = 345, year = 1988 }