title: Grey matter brain injuries are common in Ugandan children with cerebral palsy suggesting a perinatal aetiology in full-term infants.
abstract: OBJECTIVE
  There is limited literature on brain imaging studies of children with cerebral palsy (CP) in low and middle income countries. We investigated neuroimaging patterns of children with CP attending a tertiary referral centre in Uganda to determine how they differed from studies reported from high income countries and their relationship with prenatal and postnatal factors.
  
  
  METHODS
  Precontrast and postcontrast computed tomography (CT) scans of 78 CP children aged 2-12 years were conducted using a Philips MX 16-slice CT scanner. Two radiologists, blinded to the patient's clinical status, independently reviewed the scans.
  
  
  RESULTS
  Abnormal CT scans were detected in 69% of the children sampled, with very few having primary white matter injuries (4%). Primary grey matter injuries (PGMI) (44%) and normal scans (31%) were most frequent. Children with a history of hospital admission following birth were three times more likely to have PGMI (odds ratio [OR] 2.8; 95% CI 1.1-7.1), suggesting a perinatal period with medical complications.
  
  
  CONCLUSIONS
  Brain imaging patterns in this group of CP children differed markedly from imaging studies reported from high income countries, suggesting a perinatal aetiology in full-term infants and reduced survival in preterm infants.
authors.affiliation: Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda.|Astrid Lindgren Children's Hospital, Department of Women's & Children's Health, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Angelina
authors.initials: A
authors.lastname: Kakooza-Mwesige
authors.affiliation: Mulago Hospital Department of Radiology/Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Rosemary K
authors.initials: RK
authors.lastname: Byanyima
authors.affiliation: Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: James K
authors.initials: JK
authors.lastname: Tumwine
authors.affiliation: Astrid Lindgren Children's Hospital, Department of Women's & Children's Health, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Eliasson
authors.affiliation: Astrid Lindgren Children's Hospital, Department of Women's & Children's Health, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Forssberg
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet and Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Olof
authors.initials: O
authors.lastname: Flodmark
mesh_terms: D002547:Cerebral Palsy / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D014454:Uganda / Q000453:epidemiology
keywords: Cerebral palsy; Children; Computed tomography scans; Grey matter injury; Uganda