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MINERVA PEDIATRICA

A Journal on Pediatrics, Neonatology, Adolescent Medicine,
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Minerva Pediatrica 2006 April;58(2):101-7

language: English

Impact of cerebral palsy in patients discharged from neonatal intensive care units

Romeo D. M. M. 1, Scoto M. 1, Conversano M. 2, Romeo M. G. 2

1 U.O. di Neuropsichiatria Infantile Dipartimento di Pediatria Università degli Studi di Catania, Catania
2 U.O. di Terapia Intensiva Neonatale Dipartimento di Pediatria Università degli Studi di Catania, Catania


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Aim. The aim of this study was to assess the impact and the peculiarities of cerebral palsy (CP) in children discharged from our neonatal intensive care unit (NICU) from January 1998 to April 2004.
Methods. A total of 2 303 children were discharged from our NICU during this period and 1 912 were followed up for 1 year through neurological examination (traditional, Brazelton, general movements) and cranial ultrasound (US); high-risk newborns were evaluated with brain magnetic resonance imaging (MRI) too.
Results. In 65 children (3.4% of the follow-up group) were diagnosed CP, and classified as follows: 21 (32%) diplegia, 19 (29%) quadriplegia, 20 (31%) hemiplegia, 4 (6%) double hemiplegia, 1 (2%) dyskinetic form. In diplegia and quadriplegia prevailed low birth weight infants (less than or equal to 2 500 g) and preterm infants, while in hemiplegia prevailed normal birthweight infants (greater than 2 500 g) and infants at term. The main MRI findings were: in diplegia 82% periventricular white matter lesions; in quadriplegia 94% periventricular and/or subcortical white matter lesions; in hemiplegia 95% bilateral periventricular or subcortical white matter lesions, predominating on contralateral cerebral hemisphere; in double hemiplegia 100% periventricular and/or subcortical white matter lesions, 100% enlargment of subarachnoid spaces; in dyskinetic form 100% basal ganglia lesions.
Conclusion. The impact of CP in children discharged from our NICU, in agreement with the literature, is higher than in the total population of newborns, thus it is very important to evaluate carefully high-risk newborns during hospitalization and follow-up, through neurological examination and radiologic imaging (US, MRI), for an accurate and early treatment.

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