title: A magnetic resonance imaging finding in children with cerebral palsy: Symmetrical central tegmental tract hyperintensity.
abstract: BACKGROUND
  Central tegmental tract is an extrapyramidal tract between red nucleus and inferior olivary nucleus which is located in the tegmentum pontis bilaterally and symmetrically. The etiology of the presence of central tegmental tract hyperintensity on MRI is unclear.
  
  
  OBJECTIVE
  In this study our aim is to evaluate the frequency of central tegmental tract lesions in patients with cerebral palsy and control group, as well as to determine whether there is an association between central tegmental tract lesions and cerebral palsy types.
  
  
  METHODS
  Clinical and MRI data of 200 patients with cerebral palsy in study group (87 female, 113 male; mean age, 5.81years; range, 0-16years) and 258 patients in control group (114 female, 144 male; mean age, 6.28years; range, 0-16years) were independently evaluated by two reader for presence of central tegmental tract hyperintensity and other associated abnormalities.
  
  
  RESULTS
  Central tegmental tract hyperintensities on T2WI were detected in 19% of the study group (38/200) and 3.5% of the control group (9/258) (p<0.0001). Among the total of 38 central tegmental tract lesions in study group, the frequency of central tegmental tract hyperintensity was 16% (24/150) in spastic cerebral palsy and 35% (14/40) in dyskinetic cerebral palsy (p=0.0131).
  
  
  CONCLUSIONS
  The prevalence of central tegmental tract hyperintensity is higher in patients with cerebral palsy particularly in dyskinetic type. We suggest that there is an increased association of the tegmental lesions with dyskinetic CP. Patients with cerebral palsy and ischemic changes were more likely to have central tegmental tract lesions. According to our results we advocate that an ischemic process may have a role in the etiopathogenesis.
authors.affiliation: Gazi University School of Medicine, Department of Radiology, Division of Pediatric Radiology, Besevler, Ankara, Turkey. Electronic address: betulemineyildiz@gmail.com.
authors.forename: Betul Emine
authors.initials: BE
authors.lastname: Derinkuyu
authors.affiliation: Istanbul University Cerrahpasa Medical School, Department of Radiology, Istanbul, Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Ozmen
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Radiology, Ankara, Turkey.
authors.forename: Havva
authors.initials: H
authors.lastname: Akmaz-Unlu
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Radiology, Ankara, Turkey.
authors.forename: Namik Kemal
authors.initials: NK
authors.lastname: Altinbas
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Gurkas
authors.affiliation: Gazi University School of Medicine, Department of Radiology, Division of Pediatric Radiology, Besevler, Ankara, Turkey.
authors.forename: Oznur
authors.initials: O
authors.lastname: Boyunaga
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008636:Mesencephalon / Q000473:pathology / Q000503:physiopathology; D015995:Prevalence; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology
keywords: Central tegmental tract; Cerebral palsy; Magnetic resonance imaging