3 – Pathogenesis of cerebral palsy
Myers (1972) used a radioactive tracer to investigate
alterations of blood flow in the brains of monkey
fetuses subjected to in utero partial asphyxia.
Decreased blood flow was revealed throughout the
gray matter of the cerebral cortex. The brainstem was
little affected. The cerebellum exhibited zones of
diminished perfusion.
That circulation within the brainstem was affected to a
lesser degree than the cerebral cortex was not
discussed further in this paper. However,
preservation of blood flow to the brainstem under
conditions of partial circulatory compromise should be
contrasted with the immediate vulnerability of
brainstem nuclei to total asphyxia.
Patterns of cortical injury caused by partial asphyxia
were found to be variable and formed a spectrum from
total hemispheral necrosis to circumscribed damage of
the "paracentral region" of the cerebral cortex. The
paracentral region of the cortex refers to brain areas
around the central sulcus of each hemisphere. The
precentral gyrus (or motor cortex) is just forward of
this gyrus and is where motor movements are initiated
from the cortex. The post-central gyrus
(somatosensory cortex) is just posterior to the central
sulcus and is the end-target in the cortex for
sensations of touch, pressure, temperature, and pain
from the skin.
Myers commented that "classical patterns of brain
damage" from perinatal injury in the human infant
involve the same paracentral structures of the cortex,
and are associated with the pathology of cerebral
palsy. He suggested therefore that "in utero partial
asphyxia may play a major role in the pathogenesis of
cerebral palsy" [1, p269].
- Myers RE (1972) Two
patterns of perinatal brain
damage and their
conditions of occurrence.
Reference