A Michigan boy with cerebral palsy and hydrocephalus is going on a bike trip with his classmates and friends for the first time, thanks to a charity called Watermark for Kids, which helps under-served children meet goals they aren’t financially capable of meeting on their own. The organization had a bike custom built for Chris, who is fourteen years old and finishing his last year of middle school. Chris’s bike is attached to a tandem bike, which makes it incredibly unique. The bike is essentially 3 bicycles in one. The two people on the tandem bike are able to pull the third bike, which is a modified tricycle. Of course, Chris is able to use the pedals, making the 3-person custom bike a real team effort.
Today, Chris begins his 250 mile trip throughout the beautiful west coast of Michigan. He is riding with a group of friends from his school and church. Chris says he feels a lot more confident because now he feels as if he can truly ride a bike. It is a dream come true, and although anxious, Chris is very excited.
Chris’s father, Gary, choked back tears when the bike was presented to Chris. Gary said the bike is wonderful because a lot of times, other kids do activities that Chris just can’t do. This bike gives Chris freedom and a chance to do the same things his friends are doing.
What Caused Chris To Have Cerebral Palsy?
Chris’s mother had a high risk pregnancy and a traumatic delivery that caused Chris to experience a lack of oxygen to his brain. She thought Chris was perfectly healthy when she brought him home, however. But when Chris was 6 months old, she noticed that his head seemed unusually large. She told Gary that Chris just didn’t look normal.
The Brandt’s took Chris to the pediatrician, who said that Chris should have an MRI of his head done right away. The same day the MRI was performed, the doctor called the family and told them that Chris has hydrocephalus, which is a build of fluid in the brain.
Shortly after the diagnosis of hydrocephalus, Chris was diagnosed with spastic cerebral palsy. Specifically, Chris has spastic diplegic cerebral palsy, which means he has extreme tightening of his leg muscles. This makes it very difficult for Chris to walk. Chris has had some medical procedures over the years, including botox shots in his legs, which he became immune to at age 7. He also had leg braces until he had a surgery called selective dorsal rhizotomy (SDR).
With intense physical therapy, Chris has gotten better control of his legs, although he still struggles. He is diligent with his therapy, and he hopes that doing outdoor activities will help his overall coordination and motor function.
What Is Hydrocephalus And What Causes It?
When a baby experiences head trauma and/or a lack of oxygen to the brain during or near the time of delivery, the brain can become seriously injured. Oxygen deprivation (hypoxia) and trauma can cause bleeding inside the ventricles of the brain, called an intraventricular hemorrhage (IVH). This can lead to significant swelling of the ventricles, called hydrocephalus. The swelling is caused by too much cerebral spinal fluid (CSF). Hydrocephalus can lead to injured blood vessels and destruction of white matter in the brain, and the cerebral cortex–a very important part of the brain–may not develop properly.
White matter is important because it regulates the electrical signals between brain cells. It is responsible for transmitting information throughout the brain, to the spinal cord, and outside the brain to the rest of the body. The cerebral cortex plays a role in movement, memory, attention, perceptual awareness, thought, language and consciousness.
Hydrocephalus often begins with an injury to the brain that causes a brain bleed, usually IVH. Premature babies are more susceptible to IVH because blood vessels and other parts of their brains are fragile. Conditions that can cause IVH in a term or premature baby include the following:
- Hypoxic ischemic encephalopathy (HIE, lack of oxygen or blood flow to the brain)
- Trauma from prolonged labor
- Trauma from a difficult birth, which can occur when a baby is large for its gestational age (macrosomic), the mother has cephalopelvic disproportion (CPD), or forceps or vacuum extractors are used to facilitate delivery. Forceps and vacuum extractors place a baby at high risk of having a brain bleed
- Oxygen deprivation or head trauma from use of Pitocin or Cytotec
- Abnormal presentation that causes head trauma, such as a breech or face presentation
- Abnormal changes in blood pressure
The most common cause of after birth hydrocephalus in a baby is a germinal matrix hemorrhage (GMH), also known as a periventricular-intraventricular hemorrhage. GMH usually occurs in premature infants.
What Is Spastic Cerebral Palsy?
Spastic cerebral palsy is the most common type of cerebral palsy, occurring in approximately 70-90% of all cases. Normally, muscles coordinate in pairs; when one group of muscles contract (tighten), the other group relaxes. This allows free and coordinated movement. In spastic cerebral palsy, problems with brain-to-nerve-to-muscle communication occur. This causes muscle tension to be abnormal, with muscles failing to work together. Instead, opposing muscle groups become active at the same time, which prevents coordinated movement and causes spasticity. Children with spastic cerebral palsy have stiff, jerky movements and struggle with walking and remaining upright.
The main difference between spastic cerebral palsy and a normal pattern of movement is the “scissor gait.”
Scissor gait is characterized by the following:
- “Tip toe” walking
- Knees and thighs may cross or touch while walking
- Hips and pelvis are often locked, as if crouching while walking
- Ankles may be turned inwards while walking
- Arms and hands may go outwards from the body to provide balance
Spasticity varies widely from child to child. Balance problems and/or stiffness in movement can range from barely noticeable to misalignments so pronounced that the child needs crutches or a cane to assist in being upright. Above the hips, children with spastic diplegia typically have normal or near-normal muscle tone and range of motion, though some spasticity may also affect the upper body. Because leg tightness often leads to instability when upright, extra muscle tension usually develops in the upper body due to the upper body trying to compensate for the instability of the lower body.
What Is The Treatment For Spastic Cerebral Palsy?
Selective dorsal rhizotomy (SDR) is a surgery whereby the surgeon goes into the child’s spinal cord and selects the nerves that are causing spasticity and cuts them. Once these nerves are cut, the child’s spasticity should be gone or significantly decreased. Of course, it takes many months of aggressive physical therapy to maximize the benefits of SDR, and the physical therapy has to be continued throughout the child’s lifetime.
There are other surgeries and treatments for spastic cerebral palsy, but these treatments do not show a benefit that is as significant and long-lasting as selective dorsal rhizotomy. Indeed, SDR is a permanent treatment. In addition to aggressive physical therapy, there are numerous complementary treatments available to help children with cerebral palsy.
Reiter & Walsh: Advocates For Children With Cerebral Plasy, HIE, And Hydrocephalus
The nationally recognized lawyers at Reiter & Walsh ABC Law Centers have been helping children with HIE, hydrocephalus and cerebral palsy throughout the nation for almost 3 decades. Jesse Reiter, the firm’s president, has been focusing on birth injury cases his entire 28-year career. Jesse and his team help children all over the country, and when they take a case, they spend a lot of time getting to know the child and family they are helping so they can fully understand the child’s needs.
Jesse has won many awards for his advocacy of children, and he is currently recognized as being one of the best medical malpractice lawyers in America by U.S. News and World Report 2014, as well as one of the 10 Best Attorneys in Michigan by Super Lawyers magazine. Reiter & Walsh ABC Law Centers is also recognized as being one of the best medical malpractice law firms in the country by U.S. News and World Report 2014.
Jesse and his team are passionate about helping children obtain all the support, therapy and treatment they need so they have a good quality of life and a secure future. The team will carefully review all medical records to determine if negligence occurred. Once the lawyers see medical malpractice, they aggressively fight to obtain compensation for lifelong care and support of the child, which typically includes treatment, medical devices, housing and education.
Birth injury law is a difficult area of law to pursue due to the complex nature of the medical records. The award winning lawyers at Reiter & Walsh have decades of experience with birth injury, hypoxic ischemic encephalopathy and cerebral palsy cases. To find out if you have a case, contact our firm to speak with an experienced cerebral palsy lawyer. We have numerous multi-million dollar verdicts and settlements that attest to our success, and no fees are ever paid to our firm until we win your case. Email or call us at 888-419-2229. Our attorneys are available 24/7 to speak with you.