6. Neuroimaging in cerebral palsy

Head CT scan commonly identifies abnormalities, particularly in spastic CP. Cerebral atrophy is a frequent finding in quadriplegia, whereas infarction, porencephalic cyst, and cerebral atrophy occur equally (26.7%) in hemiplegic CP, and periventricular leukomalacia is significantly more common with diplegia. A brain abnormality seen on CT scan has been reported in 77% of the cases of hemiplegia, followed by quadriplegia (75%) and diplegia (55%) [11], while other studies showed CT abnormalities in 77.2% of patients, with bilateral atrophy in 42.1% and focal findings in 17.6% of the cases [12].

MRI scan is an important and safe diagnostic tool to use in children with CP after 18 months in order to assess location, nature, and structure of brain lesion and correlate findings with clinical picture.

The patterns of MRI in children with cerebral palsy are as follows:

• White matter damage, observed more often in spastic diplegia and quadriplegia.
