Reorganization after pre- and perinatal brain lesions.

Journal of Anatomy
Martin Staudt

Abstract

The developing human brain can compensate for pre- and perinatally acquired focal lesions more effectively than the adult brain. The mechanisms by which this effective reorganization is achieved vary considerably between different functional systems, reflecting differences in the normal maturation of these systems. In the motor system, descending cortico-spinal motor projections have already reached their spinal target zones at the beginning of the third trimester of pregnancy, with initially bilateral projections from each hemisphere. During normal development, the ipsilateral projections are gradually withdrawn, whereas the contralateral projections persist. When, during this period, a unilateral brain lesion disrupts the cortico-spinal projections of one hemisphere, the ipsilateral projections from the contralesional hemisphere will persist. This allows the contralesional hemisphere to take over motor control over the paretic extremities. Although this mechanism of reorganization is available throughout the pre- and perinatal period, the efficacy of this ipsilateral takeover of motor functions decreases with increasing age at the time of the insult. In the somatosensory system, ascending thalamo-cortical somatosensory projec...Continue Reading

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