Cerebral Imaging (CT/MRI): Consequences for Neurorehabilitation

Background/Purpose: Almost all patients with severe affections of the brain receive CTs or MRIs in the acute phase of their disease. These investigations yield import information for surgical and non-surgical therapeutic measures in the acute phase. In addition, with a good knowledge of functional anatomy, these investigations allow a detection of specific functional deficits, often at a time when these deficits are not yet evident during physical examination. Furthermore, when the rules of neuroplasticity in the developing brain are known, these images yield important information also for the prognosis of these deficits. These correlations are usually not mentioned in neuroradiological reports. Therefore, the pediatric neurologist (leading the therapeutic team) must reanalyze these images, draw the relevant conclusions, and demonstrate and communicate them with the team.

Methods: For patients admitted for neurorehabilitation in our institution, we request CT and MRI investigations from the referring hospitals on CD-ROM, and re-analyze these images systematically with respect to neurorehabilitative information.

Results: Frequent radiologically identified deficits are: Cerebral visual impairment (global/hemianopia), dysarthria (vs. aphasia) in children with bilateral lesions to the primary-sensorimotor face areas or their tracts/of the basal ganglia. Frequent radiology-based prognoses are permanent loss of active hand function (destruction of primary motor hand area or its corticospinal tracts) and persisting aphasia (severe destruction of language areas beyond kindergarten age). In addition, more complex correlations can be helpful for therapeutic work, such as explaining a global perception problem with bi-parietal lesions or deficits in impulse control with bi-frontal lesions.

Conclusion: Analyzing brain imaging studies in the context of neurorehabilitation can yield important information for goal-finding and choosing adequate therapeutic measures.

Die Autoren geben an, dass kein Interessenkonflikt besteht.