RADIOLOGICAL ASPECTS OF CEREBRAL PALSY (CP) IN ABIDJAN BOA SCN 2, DOUMBIA-OUATTARA M 1,2, KOUASSI L 1,2, DIAKITE I 1,2, BROH Y 2, SONAN DT 1,2 1: UFR Medical Sciences, UFHB Abidjan Côte d’Ivoire 2 Neurology unit Teaching Hospital Yopougon 22nd PAANS Conference, Kampala Uganda, 6 June

INTRODUCTION DEFINITION CP:«Group of disorders that affect a person’s ability to move and maintain balance and posture, caused by abnormal brain developpement or damage to the developing brain». DIAGNOSIS: based on brain lesions detected by Magnetic Resonance Imaging ( MRI) 2

CONTENT 1- METHODOLOGY 2- RESULTS 3- COMMENTS 3

AIMS 1 - Describe the radiological aspects of CP brain lesions in Abidjan. 2 - Precise contribution of brain scan in the diagnosis of CP. 4

METHODOLOGY(1) Setting : Neuropaediatrics consultation unit of the Teaching Hospital of Yopougon. Type and period : Retrospective and descriptive study; Population sample : 40 CP recorded. 5

METHODOLOGY(2) Parameters -Demographics: Age and sex - Radiologica l : Brain Scan and MRI Brain Scan: 38 patients (95%) MRI : 3 patients (7.5%) MRI + Brain Scan: 2 patients (5%). 6

RESULTS  Demographics parameters -Sex ratio : 1.85 ( 65% male ) -Mean age: 2.73 years  Radiological aspects - Cortico-subcortical atrophy: 50% -Gray matter lesions : 12.5% -White matter lesions : 12.5% -Other lesions : 25 % 7 RESULTS

CORTICO-SUBCORTICAL ATROPHY TOPOGRAPHY-DIFFUSE : 30% -PREDOMINANT ON ONE LOBE: 12,5% -UNILATERAL : 7,5% ISOLATED35% ASSOCIATED- WHITE MATTER : 5% - GRAY MATTER : 5% - OTHER LESIONS: 5% 8

GRAY MATTER LESIONS = 12.5% - Cerebral ischemia : 7.5% - Cyst in brain parenchyma and cortex : 2.5% - Hypodense bilateral thalamic lacuna : 2.5% 9

WHITE MATTER LESIONS = 12.5% - Bilateral fronto-parietal leucomalacia : 5% - Demyelination of periventricular white matter mainly occipital : 2.5% - Lateral periventricular calcification : 2.5% - Microcalcification in semi oval center : 2.5% 10

OTHER LESIONS = 25% - Hydrocephalus : 12.5% - Fronto-parietal pachymeningitis : 5% - Frontal arachnoidal cyst : 2.5% - Craniostenosis : 5% 11

CORTICO SUBCORTICAL ATROPHY 12

ANOXIA -ISCHEMIA ENCEPHALOPATHY 13

BILATERAL INFARCTS 14

COMMENTS (1)  Diagnosis of CP -Based on MRI according to the literature data. - Brain scan detects less lesions than MRI - MRI : value in the etiology value in the dating of the causal event KORZENIEWSKI and al, J Child Neurol 2008; 23:216 CHABROL B and al, Neurologie pédiatrique, 2010,

COMMENTS (2) Our study: 40 patients and 3 MRI - Topography : main lesion = cortico subcortical atrophy -financial and geographical accessibility of MRI. Main lesion in the white matter ( BAX and GAHA ) MRI done in all patients: GAHA and al. More patients : 351 patients ( BAX and al.) BAX and al, Journal of the American Medical Association 2006;296(13):1602 GAHA et al, journal de radiologie 2009, vol.90(10) Elsevier 16

CONCLUSION  MRI is the main neuroradiological tool for  diagnosis and exploration of CP  topography of lesion  value for etiology of CP.  However, brain scan can contribute to the diagnosis in our working area. 17

THANK YOU 18

BIBLIOGRAPHY 1 - Handicaps Neurologiques. CHABROL B and al, Neurologie pédiatrique, 3 e édition, 2010, 823; Medecine-Sciences, Flammarion 2 - Clinical and MRI Correlates of Cerebral Palsy: The European Cerebral Palsy Study BAX and al, Journal of the American Medical Association 2006;296(13): A Systematic Review of Neuroimaging for Cerebral Palsy KORZENIEWSKI and al, J Child Neurol 2008; 23: Aspects en IRM et corrélation clinique de l’infirmité motrice cérébrale GAHA et al, journal de radiologie 2009, vol.90(10) Elsevier 5- Cerebral palsy definition. 19