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CONGENITAL DISORDERS (CEREBRAL PALSY) (PATHOPHYSIOLOGY ((Cerebral injury…
CONGENITAL DISORDERS (CEREBRAL PALSY)
PATHOPHYSIOLOGY
Cerebral injury before the 20th week of gestation can result in a neuronal migration deficit.
Injury between the 26th and 34th weeks can result in periventricular leukomalacia (foci of coagulative necrosis in the white matter adjacent to the lateral ventricles).
Injury between the 34th and 40th weeks can result in focal or multifocal cerebral injury.
Brain injury due to vascular insufficiency depends on various factors at the time of injury, including the vascular distribution to the brain, the efficiency of cerebral blood flow and regulation of blood flow, and the biochemical response of brain tissue to decreased oxygenation
CLINICAL MANIFESTATION
Developmental delay. History of gross motor developmental delay in the first year of life.
Abnormal muscle tone. The most frequently observed symptom; the child may present as either hypotonic or, more commonly, hypertonic, with either decreased or increased resistance to passive movements,
Hand preference. Definite hand preference before age 1 year: A red flag for possible hemiplegia.
Problems in crawling. Asymmetrical crawling or failure to crawl.
Growth disturbance. There is a growth disturbance especially in failure to thrive.
Increased reflexes. Indicating the presence of an upper motor neuron lesion; this condition may also present as the persistence of primitive reflexes.
Problems in reflexes. Underdevelopment or absence of postural or protective reflexes.