95 A Comparison of the Developmental Profiles of Individuals with Hemiplegic Cerebral Palsy associated with Middle Cerebral Artery and Periventricular Venous Infarctions

• Published in: Paediatrics & child health 2019-05, Vol.24 (Supplement_2), p.e36-e37
• Main Authors: Fehlings, Darcy, Krishnan, Pradeep, Ragguett, Renee Marie, Campbell, Craig, Gorter, Jan Willem, Hunt, Carolyn, Kawamura, Anne, Kim, Marie, McCormick, Anna, Mesterman, Ronit, Samdup, Dawa, Walters, Ilana, deVeber, Gabrielle
• Format: Article
• Language: English
• Subjects: Abstract / Résumés; Cerebral palsy; Medical imaging; Pediatrics; Rehabilitation; Traumatic brain injury
• ISSN: 1205-7088; 1918-1485
• DOI: 10.1093/pch/pxz066.094

Background We lack knowledge of the developmental profiles of different brain injuries in hemiplegic cerebral palsy (HCP). This is important because children with specific injury patterns may respond differently to rehabilitation interventions. Objectives To assess the relative proportion of brain injury patterns in HCP and compare the developmental profile of children with middle cerebral artery (MCA) and periventricular venous infarctions (PVI). Design/Methods Children aged 2–18 years with a diagnosis of HCP were recruited from 9 children’s rehabilitation hospitals and informed consent was obtained. Developmental and neuroimaging information were collected from 6 sources: 1) data extraction from the health record, 2) brain imaging categorized by a neuroradiologist, 3) administration of the Quality of Upper Extremity Skills Test (QUEST) and classification of Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) by an occupational therapist, 4) child/parent questionnaires on hand usage: the Children’s Hand-use Experience Questionnaire (CHEQ) or Pediatric Upper Extremity Motor Activity Log (PMAL), 5) physician-administered sensory exam and 6) full scale intelligence quotient (IQ). Two groups comprising the most prevalent brain injury patterns were compared using a cross-sectional study design. Results Of 321 recruited, 246 (76.6%) had neuroimaging and were included in the analyses. The mean age was 8.30± 4.28, GMFCS I (n=181, 77.0%) and II (n=39, 16.6%), MACS I (n=82, 35.3%), II (n= 101, 43.5%). Neuroimaging revealed MCA infarctions (n=98, 39.8%), periventricular white matter lesions (n=110, 44.7%) of which periventricular venous infarction (PVI) was present in n=41, (16.7%), miscellaneous (n=8, 3.3%), unilateral malformations (n=19, 7.7%), non-MCA arterial infarctions (n=3, 1.2%), and normal imaging (n=8, 3.3%). Comparing PVI to MCA, the QUEST total score was higher in PVI, with 79.43±16.96 compared to 49.79±31.39 in MCA (t = 5.48, p value