scholarly journals MR-patterns of brain’s hypoxic-ischemic lesions in term newborns

2017 ◽  
Vol 8 (6) ◽  
pp. 86-93
Author(s):  
Tat'yana V. Melashenko ◽  
Aleksandr V. Pozdnyakov ◽  
Viktor S. Lvov ◽  
Dmitry O. Ivanov
Keyword(s):  
Brain Damage ◽  
Neurological Disorders ◽  
Cortical Neurons ◽  
Developed Countries ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Infants ◽  
Basal Nuclei ◽  
Term Newborns ◽  
Ischemic Encephalopathy

Perinatal hypoxic-ischemic encephalopathy (HIE) remains a major cause of neonatal mortality and development of severe neurological disorders that determine the quality of life of these children. In developed countries, the frequency of detection of hypoxic-ischemic encephalopathy (HIE) among full-term newborns is 1-6 per 1.000 live births. In our country, hypoxic-ischemic brain damage is observed in 15-30% of full-term newborns. The term HIE is a clinical diagnosis combining neurological disorders and biochemical changes caused by perinatal HI (hypoxiа-ischemia). The pattern of acute brain damage depends on the degree of cerebral maturity, the severity and duration of hypoxiа-ischemia. The most vulnerable regions are the structures of the brain with high level of metabolism. Such structures in term infants include cortical neurons and neurons of basal nuclei, a subcortical white matter. MRI allows to diagnose brain lesions in term infants in the acute period of HIE. Safety, non-invasiveness and large diagnostic capabilities of MRI allow this method to be considered the gold standard of neuroimaging in neonatology. In this review we described the main MRI patterns of brain injury in term neonates following HIE.

scholarly journals Early predictors of brain damage in full-term newborns with hypoxic ischemic encephalopathy [Corrigendum]

2017 ◽  
Vol Volume 13 ◽  
pp. 2255-2256
Author(s):  
Usama M. Alkholy ◽  
Nermin Abdalmonem ◽  
Ahmed Zaki ◽  
Yasser F Ali ◽  
Soma Mohamed ◽  
...  
Keyword(s):  
Brain Damage ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Predictors ◽  
Term Newborns ◽  
Ischemic Encephalopathy

scholarly journals Early predictors of brain damage in full-term newborns with hypoxic ischemic encephalopathy

2017 ◽  
Vol Volume 13 ◽  
pp. 2133-2139 ◽  
Author(s):  
Usama M. Alkholy ◽  
Nermin Abdalmonem ◽  
Ahmed Zaki ◽  
Yasser F Ali ◽  
Soma Mohamed ◽  
...  
Keyword(s):  
Brain Damage ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Predictors ◽  
Term Newborns ◽  
Ischemic Encephalopathy

scholarly journals Is Erythropoietin Combining with Therapeutic Hypothermia an Efficient and Safe Therapy in Neonatal Hypoxic Ischemic Encephalopathy: A Prospective and Randomized Clinical Trial

2020 ◽  
Author(s):  
Liang-yan Zou ◽  
Bing-xue Huang ◽  
Peng Zhang ◽  
Guo-qiang Cheng ◽  
Chun-mei Lu ◽  
...  
Keyword(s):  
Brain Injury ◽  
Adverse Events ◽  
Therapeutic Hypothermia ◽  
Brain Mri ◽  
Adverse Outcomes ◽  
Hypoxic Ischemic Encephalopathy ◽  
Control Group ◽  
Term Infants ◽  
Basal Nuclei ◽  
Ischemic Encephalopathy

Abstract BackgroundTo evaluate the efficacy and safety of erythropoietin (Epo) combined with therapeutic hypothermia (TH) in neonatal hypoxic-ischemic encephalopathy (HIE).MethodsA total of 78 term infants with HIE were assigned randomly to receive Epo (n = 40) or placebo (n = 38). All infants received TH. Blood samples before TH, after TH and after Epo/placebo were collected for measuring TH associated adverse events, Epo associated factors and potential neural biomarkers. Basal ganglia/ watershed (BG/W) scoring system was used to assess brain injury in MRI. Neurodevelopmental evaluations were performed at 18 months by using BayleyScales of Infant Development II (Bayley II).ResultsEpo-treated group tend to have lower serum creatine kinase (CK) concentration (114 vs 202, P = .04) and higher serum K+, Mg2+ concentration (5.0 vs 4.5, P = .03; 1.0 vs 0.9, P = .02) than control group after intervention. Brain MRI was performed in 65 (83%) neonatal. Totally brain injury score was in even distribution between two groups (median, 0 vs 0, P = .61), but injury region in cortex plus basal nuclei comparing with in basal nuclei solely was less common in the Epo than in the control group (21% vs 31%, P = .046). Only forty patients (40/78, 51%) succeeded in achieving 18-month follow up data. The totally adverse outcomes were trend to decline in the Epo group (35% vs 60%, P = .21). No adverse events were ascribed to Epo treatment.ConclusionsThe combination of Epo and TH is proved to be feasible, safe and potential effective.Trial registration: ChiCTR-TRC-14004532, date of registration: April 18th, 2014.

Early Prediction of the Development of Microcephaly After Hypoxic-Ischemic Encephalopathy in the Full-term Newborn

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 151-152
Author(s):  
Nadia Badawi ◽  
Jennifer J. Kurinczuk ◽  
Eve Blair ◽  
John Keogh ◽  
Fiona Stanley
Keyword(s):  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Prediction ◽  
Underlying Assumption ◽  
Term Newborn ◽  
Neurological Signs ◽  
Term Newborns ◽  
Ischemic Encephalopathy

We read with interest the article by Cordes et al.1 This article raises an important issue concerning assumptions made with respect to the significance of intrapartum and neonatal observations. The population of infants studied was 54 full-term newborns born after uneventful pregnancies and diagnosed as having acute hypoxic-ischemic encephalopathy (HIE) that was intrapartum in origin. The underlying assumption of this diagnosis was that if there is no obvious antenatal cause of abnormal neonatal neurological signs, then any suboptimal intrapartum observation identifies the pathology as being intrapartum in origin.

Early Prediction of the Development of Microcephaly After Hypoxic-Ischemic Encephalopathy in the Full-Term Newborn

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 703-707
Author(s):  
Isabel Cordes ◽  
Elke H. Roland ◽  
Alan Hill ◽  
Brian A. Lupton
Keyword(s):  
Head Circumference ◽  
Prognostic Significance ◽  
Full Term ◽  
Cerebral Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Prediction ◽  
Term Newborn ◽  
Head Growth ◽  
Term Newborns ◽  
Ischemic Encephalopathy

The development of microcephaly after significant hypoxic-ischemic cerebral injury in the full-term newborn has major prognostic significance. However, the onset of microcephaly in this context may be delayed more than 12 months. Objectives. To determine whether serial head circumference measurements and decreased rate of head growth in asphyxiated full-term newborns during the first few months of life may predict the development of eventual microcephaly. Methodology. Serial head circumference measurements at 4, 8, and 18 months of age were obtained in 54 full-term newborns who had acute, hypoxic-ischemic encephalopathy. The rate of head growth was determined on the basis of changes in head circumference ratios which are calculated as follows: actual head circumference/mean head circumference for age x 100%. Head circumference ratios were correlated with severity of newborn encephalopathy and outcome at 18 months. Results. A decrease in head circumference ratios of >3.1% between birth and 4 months of age was highly predictive of the eventual development of microcephaly before 18 months (sensitivity 90%, specificity 85%). Conclusions. These data demonstrate that serial head circumference measurements during the first 4 months of life and calculation of decreased rate of head growth in full-term newborns with hypoxic-ischemic encephalopathy may predict microcephaly before its actual occurrence.

scholarly journals High Urinary Concentrations of Activin A in Asphyxiated Full-Term Newborns with Moderate or Severe Hypoxic Ischemic Encephalopathy

2007 ◽  
Vol 53 (3) ◽  
pp. 520-522 ◽  
Author(s):  
Pasquale Florio ◽  
Stefano Luisi ◽  
Bashir Moataza ◽  
Michela Torricelli ◽  
Iskander Iman ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Activin A ◽  
Good Prognosis ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Promising Tool ◽  
Group A ◽  
Term Newborns ◽  
Group B ◽  
Ischemic Encephalopathy

Abstract Background: Hypoxic ischemic encephalopathy (HIE) is a major cause of permanent neurological disabilities in full-term newborns. We measured activin A in urine collected immediately after birth in asphyxiated full-term newborns, and assessed the ability of the measurements to predict the occurrence of perinatal encephalopathy. Methods: We studied 30 infants with perinatal asphyxia and 30 healthy term neonates at the same gestational age. We recorded routine laboratory variables, cranial assessments by standard cerebral ultrasound, and the presence or absence of neurological abnormalities during the first 7 days after birth. Urinary activin A concentrations were measured at first urination and 12, 24, 48, and 72 h after birth. Results: Asphyxiated infants were subdivided as follows: group A (n = 18): no or mild HIE with good prognosis and group B (n = 12): moderate or severe HIE with a greater risk of neurological handicap. Activin A concentrations in urine collected at birth (median collection time at first urination <2 h) and at 12, 24, 48, and 72 h from birth were significantly (P <0.0001) higher in asphyxiated newborns with moderate or severe HIE (Group B) than in those with absent of mild HIE (group A) and controls. Concentrations did not differ between group A and controls. Activin A concentrations were >0.08 μg/L at first urination in 10 of 12 patients with moderate or severe HIE but in none of 18 patients with no or mild HIE. Conclusions: Activin A measurements in urine soon after birth may be a promising tool to identify which asphyxiated infants are at risk of neurological sequelae.

scholarly journals Ultrasonography and Magnetic Resonance Imaging of the Brain in Hypoxic Full-Term Newborns

Medicina ◽  
2013 ◽  
Vol 49 (1) ◽  
pp. 8 ◽  
Author(s):  
Aušrelė Kudrevičienė ◽  
Saulius Lukoševičius ◽  
Jūratė Laurynaitienė ◽  
Vitalija Marmienė ◽  
Rasa Tamelienė ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flow Velocity ◽  
Predictive Value ◽  
Full Term ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Imaging ◽  
Cranial Sonography ◽  
Term Newborns ◽  
Ischemic Encephalopathy

The aim of this article was to review the studies on diagnostic and prognostic value of radiological investigations (cranial sonography, Doppler ultrasonography, and magnetic resonance imaging) in the detection of hypoxic-ischemic brain injuries in full-term newborns. Materials and Methods. A systematic search of studies on the diagnostic and prognostic possibilities of radiological investigations for the detection of hypoxic-ischemic injuries in full-term newborns was performed. Results. A total of 13 prospective and 4 retrospective studies that analyzed the incidence of hypoxic-ischemic cerebral injuries, determined by means of cranial sonography, Doppler sonography, and magnetic resonance imaging, and associations with the stages of hypoxic-ischemic encephalopathy and long-term neurodevelopmental outcomes were included in this systematic review. Conclusions. Magnetic resonance imaging detects lesions in 75%–100% of cases. Magnetic resonance imaging performed at the age of 7–11 days demonstrated a high sensitivity (100%) and negative predictive value (100%) to predict unfavorable outcomes at 4 years of age. In newborns with hypoxic-ischemic encephalopathy, substantial cerebral hemodynamic alterations are detected after birth. The sensitivity and negative predictive value of cerebral blood flow velocities (peak systolic flow velocity, end-diastolic flow velocity) changes at 12±2 hours of age to predict the severity of hypoxic-ischemic encephalopathy and unfavorable outcomes at 18 months of age were found to be high (90% and 94%, respectively). A low resistive index (<0.56) at the age of 1–3 days had a specificity of 95% to predict unfavorable outcomes at 3 years of age. The data on the diagnostic and prognostic potential of cranial sonography are limited scarce and contrary.

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