title: Outcome of hemiplegic cerebral palsy born at term depends on its etiology.
abstract: OBJECTIVE
  To elucidate the etiology and its relationship to the outcomes of hemiplegic cerebral palsy (HCP).
  
  
  METHODS
  MR images and outcomes of 156 children with HCP born at term and older than three years were investigated in two major centers for cerebral palsy in Japan. Etiologies were classified into perinatal ischemic stroke (PIS), cerebral dysgenesis (CD), and others. PIS was divided into periventricular venous infarction (PVI) and two types of arterial infarction; middle cerebral artery infarction (MCAI) and deep gray matter infarction (DGMI). Initial signs and the time of presentation were investigated among the three types of PIS. As functional outcomes, laterality of paresis, age at initial walk, affected hand's function, intellectual development, and occurrence of epilepsy were compared among all the four types.
  
  
  RESULTS
  
  
  
  BACKGROUND
  PIS was found in 106 children (68%), while CD accounted for 28 (18%). Among PIS, venous infarction was more common than arterial infarction (62:44).
  
  
  RESULTS
  PVI revealed later presentation of motor asymmetry and more involvement of lower extremity as the initial sign among PIS groups. Only MCAI showed right-side predominance in laterality of paresis. DGMI related to better intellectual development and PVI showed lower occurrence of epilepsy, while there was no significant difference in affected hand's function among the four groups. PIS groups showed significantly earlier attainment of independent walk, better intellectual development, and lower occurrence of epilepsy than CD.
  
  
  CONCLUSIONS
  PVI was the most common cause of HCP born at term, and the etiology closely related to the initial signs of hemiplegia and overall outcomes.
authors.affiliation: Department of Pediatric Neurology, Morinomiya Hospital, Japan. Electronic address: kitai@omichikai.or.jp.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kitai
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Haginoya
authors.affiliation: Department of Pediatric Neurology, Morinomiya Hospital, Japan.
authors.forename: Satori
authors.initials: S
authors.lastname: Hirai
authors.affiliation: Department of Pediatric Neurology, Morinomiya Hospital, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Ohmura
authors.affiliation: Department of Pediatric Neurology, Morinomiya Hospital, Japan.
authors.forename: Kaeko
authors.initials: K
authors.lastname: Ogura
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Inui
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Wakaba
authors.initials: W
authors.lastname: Endo
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Yukimune
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Anzai
authors.affiliation: Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takezawa
authors.affiliation: Department of Pediatric Neurology, Morinomiya Hospital, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arai
mesh_terms: D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006429:Hemiplegia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D020244:Infarction, Middle Cerebral Artery / Q000503:physiopathology; D008297:Male; D059906:Neuroimaging; D011247:Pregnancy; D011379:Prognosis; D020521:Stroke / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Arterial infarction; Etiology; Hemiplegic cerebral palsy; Outcome; Periventricular venous infarction; Presumed perinatal ischemic stroke