| Popis: |
The diagnosis of spastic quadriplegia due to cerebral palsy should be made only after a detailed patient history. The patient should be assessed for prior history of prematurity, intraventricular hemorrhage, or static encephalopathy following a characteristic developmental progression of neurologic findings. MR imaging is used to assess brain anatomy, and the addition of metabolic and/or genetic testing for atypical cases should be considered. Proper patient selection for intrathecal baclofen placement can be confirmed by careful preoperative evaluation and a trial of intrathecal baclofen administered by lumbar puncture. Patients in the pediatric age range with significant medical comorbidities or with low BMI are at elevated risk of baclofen pump–related complications, which should be balanced against indications for pump placement. |
