Aims and objectives
Neonatal hypoxic-ischemic encephalopathy (HIE) in full term infants has been associated with a high risk for morbidity and mortality.
HIE is one of the most common causes of cerebral palsy (approximately 20%) and other severe neurological deficits in children.
Neonatal encephalopathy due to hipoxia-ischemia occurs in 1 to 1.5 per 1000 full term birth,
although the incidence decrease in the last years.
Prior to introduction of neuroprotection therapies,
the management of neonates with HIE was limited to supportive intensive care.
large randomized clinical...
Methods and materials
We conducted a retrospective observational study of 26 patients with perinatal moderate-severe HIE who underwent therapeutic whole body hypothermia in the Hospital Universitario Rio Hortega,
between May 2011 and September 2018.
Brain MRI (1.5 Tesla) was obtained between days 7 and 14 after birth (except in two cases where an immediate MRI study was obtained) including T1-and T2-weighted images,
Fluid Attenuated Inversion Recovery (FLAIR),
diffusion weighted imaging (DWI),
and apparent diffusion coefficient (ADC) sequences.
Contras was not used.
MRI images were evaluated by neuroradiologists and...
A total of26 newborn infants 35 or more weeks of gestation were identified.
On MRI 13 patients had no evidence of brain injury and 13 patientshad evidence of perinatally acquired lesions,
some of them overlapping patterns of brain injury.
Different patterns of brain injury we observed:
Increased signal intensity of basal ganglia and thalamus (6 patients)
Abscence of the normal increased signal intensity in the posterior limb of the internal capsule (5 patients)
Cortical abnormalities (7 patients)
Abnormal signal intensity of white matter (6 patients)....
MRI is the method of choice in infants with HIE,
recognising the relevance of the findings and predicting neurodevelopmental outcomes.
Two main patterns of injury are the most common in our report: the basal ganglia-thalamus pattern and the cortex involvement,
although the patterns often overlapped.
In our experience,
both measures of magnitude of water diffusion in cerebral tissue,
are considered to be the most sensitive sequences for detection of ischemic lesions.
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