WHITE MATTER INJURY

• Preterm newborns before 30 weeks of gestation  deficient myelination

• White matter in preterm babies  the vulnerability of premyelinating oligodendrocytes to
reactive oxygen and cerebral anatomical constitution
• Preterm newborns have impaired autoregulation of cerebral blood flow
• The combination of immature cerebrovascular anatomy, disturbed autoregulation, and
extrinsic insult exposure, such as hypoxia, ischemia, and inflammation, predisposes the
vulnerable underdeveloped brain to impairment
 KORELASI DIAGNOSIS FUNGSI
• Children with walking limitations (GMFCS IV-V) presented a greater variability in
communication abilities (CFCS II-IV)
• Most of the children who did not have limitations or had problems with speed or walking
long distances (GMFCS I-II), fed and drank safely and efficiently (EDACS I)
• All the children who presented major limitations on feeding and drinking (EDACS IV-V)
needed to be transported in a wheelchair (GMFCS V)
• Children with difficulties in manipulation and needing help (MACS II-IV) showed greater
variability in communication skills (CFCS II-IV)
• Children classified as MACS IV-V most likely present neuromuscular alterations affecting
the orofacial zone and the voluntary control of the extremities (EDACS IV-V)
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FUNCTIONAL CLASSIFICATION
SYSTEM
Tool Perihal Usia
GMFCS Kemampuan fungsional dan limitasi pada fungsi <2 tahun
motorik 2 – 4 tahun
4 – 6 tahun
6 – 12 tahun
12 – 18 tahun
CFCS Kemampuan komunikasi sehari-hari >2 tahun
MACS Fungsi lengan dan tangan (manual ability) MACS: 4 – 18 tahun
Mini-MACS Mini MACS: 1 – 4 tahun
EDACS Fungsi makan dan minum EDACS: >3 tahun
Mini-EDACS Mini EDACS: 18 – 36 bulan
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