Stroke and

Brain
Injury
Cerebral Palsy
Background
Cerebral Palsy or CP for short is a congenital disorder of movement,muscle tone,
or posture.It is common with around 200,000 cases in the United States reported
every year. Cerebral Palsy is due to abnormal brain development,often before
birth. Symptoms include exaggerated reflexes, floppy or rigid limbs, and
involuntary motions.
Pathophysiology

There are two main pathologies: Intraventricular Hemorrhage and

Periventricular leukomalacia.

Intraventricular Hemorrhage:

● Bleeding from the origin of fetal brain cells in the ventricles of

the brain
● The blood vessels around the ventricles develop late resulting
in underdeveloped blood vessels and an increased risk of IHV
● Risk of CP increases with severity
Pathophysiology
Periventricular Leukomalacia: Arises from Ischemia/Hypoxia and
Infection/Inflammation

Ischemia/Hypoxia:

● The white matter is supplied by distal segments of cerebral

arteries.
● Even though it would be safe, it is a watershed zone which
means it is vulnerable to damage from cerebral hypoperfusion
● Autoregulation of cerebral blood flow would usually protect
but is limited due to the immature vasoregulatory
mechanisms and underdevelopment of the arteriolar smooth
muscles
Pathophysiology
Infection/Inflammation:

● The process involves microglial ( brain macrophage) cell

activation and cytokine release,which causes damage to a
specific cell type in the developing brain called
oligodendrocyte

Oligodendrocytes are a type of supportive brain cells that wrap

around the neurons to form the myelin sheath: essential for white
matter development

● Intrauterine infections activate cytokines which are toxic to

premyelinating oligodendrocytes
● The oligodendrocytes have a immature defence against
Pathophysiology
IVH is hypothesized to cause PVL because of the iron rich blood which causes
iron mediated conversion of hydrogen peroxide to hydrogen radical,
contributing to oxidative damage

Excitotoxicity: A process where extracellular glutamate levels simulate

oligodendrocytes to increase calcium influx which stimulates reactive oxide
species release
Pathophysiology
Effects of Exercise
● When exercising the impairment cannot advance but can be improved with
treatment
● Intervention and physical therapy is a must for childhood

If the patients with Cerebral Palsy do exercise then they will feel and see the
following:

1. Improved sense of well being and reduction in anxiety

2. Reduction in risk of chronic disorders
3. Increased lung and heart efficiency
4. Increased strength, flexibility,mobility and coordination
5. Improved bone health
6. Weight control
Effects of Exercise
If a patient with Cerebral Palsy however chooses not to exercise they will have
the following results:

1. Cardiovascular troubles
2. Neurological difficulties
3. Respiratory problems
4. Kidney problems
5. Diabetes
6. Osteoporosis
7. Artritis
8. High Blood Pressure
9. Obesity
Sources

www.strolecenter.org

https://www.ncbi.nlm.nih.org
Work Cited
https://www.mayoclinic.org/

https://www.ncbi.nlm.nih.gov/pubmed/25112118

https://www.nchpad.org/869/4965/Exercise~Programming~for~Clients~with~Cer
ebral~Palsy

http://www.cerebralpalsy.org/information/health-fitness

http://www.pathophys.org/cerebralpalsy/#Pathophysiology