Value of MR in definition of the neuropathology of cerebral palsy in vivo.

Cerebral palsy refers to a clinical syndrome of nonprogressive motor deficits (usually spastic weakness, uncommonly choreoathetosis, rarely ataxia) of central origin with onset from early infancy. In this issue of the Journal, Truwit et al describe the MR findings in 40 patients with the clinical diagnosis of cerebral palsy (1). The purposes of their retrospective study were to define the anatomic substrates of cerebral palsy in the living patient and, from the definitions of the topography of the neuropathology and the analysis of clinical data, to suggest etiology and timing of the brain injury. The authors place particular emphasis on their conclusion that cerebral palsy is usually not related to perinatal factors. The work is relevant to the role of hypoxic-ischemic brain injury in the genesis of cerebral palsy, the means of diagnosis of hypoxic-ischemic brain injury in the neonatal period, the spectrum of the neuropathology associated with cerebral palsy and the role of MR in the later definition of this neuropathology, and the timing of etiologic factors. These issues are discussed in sequence.