• Sanja Delin, Katarina Bošnjak Nađ, Sunčica Martinec, Dunja Čokolić Petrović, Andrea Šimic Klarić, and Vlatka Mejaški Bošnjak.
• 1Zadar General Hospital, Department of Pediatrics, Zadar, Croatia; 2School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Special Hospital for Developmental Neurology and Rehabilitation, Zagreb, Croatia; 4Krapinske Toplice Special Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia; 5Osijek University Hospital Centre, Department of Pediatrics, Osijek, Croatia; 6Požega General Hospital, Department of Pediatrics, Požega, Croatia; 7Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia.
• Acta Clin Croat. 2020 Jun 1; 59 (2): 260-269.

AbstractThe aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the Magnetic Resonance Imaging Classification System (MRICS) that was analogously applied to the neonatal/early infant cranial ultrasound (CUS). The study included children born during the 2004-2007 period from the Croatian part (C28 RCP-HR) of the Surveillance of Cerebral Palsy in Europe (SCPE) CP register. Motor functions, accompanying impairments and brain MRI were evaluated in 227 children, 185 of which also had CUS. Concerning CP types, 56% of children had bilateral spastic, 34% unilateral spastic, 9% dyskinetic and 1% ataxic CP type. Gross Motor Function Classification System (GMFCS) revealed that 62.05% had mild (GMFCS I-III) and 37.85% had severe motor impairment (GMFCS IV-V). CUS showed white matter injury in 60%, gray matter injury in 12%, maldevelopments in 8%, miscellaneous changes in 14%, while 6% were normal; MRI showed significant agreement (κ=0.675, p<0.001). Neuroimaging findings of maldevelopments and predominant gray matter injury were associated with more severe CP, but 7% of children with CP had normal MRI. As we found very good agreement between CUS and MRI findings, CUS is recommended in children at an increased risk of CP if MRI is not available.

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