Etiology and Pathophysiology of Postasphyxial Brain Damage

1991 ◽  
Vol 7 (S1) ◽  
pp. 106-109 ◽  
Author(s):  
Ingemar Kjellmer
Keyword(s):  
Brain Damage ◽  
Perinatal Asphyxia ◽  
Cerebral Injury

In spite of major developments in prenatal supervision, perinatal asphyxia remains an important reason for the development of brain damage (18). Epidemiological investigations suggest that perinatal asphyxia actually represents a factor of increasing frequency as a cause of severe cerebral injury (9).

scholarly journals The Role of S100B Protein at 24 Hours of Postnatal Age as Early Indicator of Brain Damage and Prognostic Parameter of Perinatal Asphyxia

2019 ◽  
Vol 6 ◽  
pp. 2333794X1983372
Author(s):  
Qiu Luo ◽  
Tamis Pin ◽  
LiFen Dai ◽  
GuiXian Chen ◽  
YuTong Chen ◽  
...  
Keyword(s):  
Brain Damage ◽  
Likelihood Ratio ◽  
Calcium Binding ◽  
Perinatal Asphyxia ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cytosolic Calcium ◽  
S100b Protein ◽  
Postnatal Life ◽  
Serum S100b

Introduction. S100B protein is a cytosolic calcium-binding protein with a molecular weight of 21 kDa, which is present in various cells and concentrated mainly in the glial cells, which play a vital role in the maintenance of cellular homeostasis in the central nervous system. It is possible that increased S100B protein level might be considered as sensitive and specific indicator to predict early brain damage. Aim. To investigate the prognostic value of serum S100B protein in neonates with perinatal asphyxia (PA) at 24 hours of postnatal age. Methods. A systematic review was performed. Inclusion criteria were studies including data of neonates with PA, monitored with serum S100B, and with neurodevelopmental follow-up of at least 2 weeks. The period of bibliographic search was until January 2017. The consulted databases were MEDLINE, PsycINFO, and Embase. A combination of the following subject headings and keywords was adapted for each electronic database: “perinatal asphyxia,” “hypoxic ischemic encephalopathy,” “hypoxia-ischemia, brain,” and “S100B.” Meta-Disc1.4 software was used. Results. From the 1620 articles initially identified, 6 were finally included and reviewed. The overall diagnostic sensitivity of serum S100B was 0.80 (95% confidence interval [CI] = 0.68-0.88) and the specificity was 0.79 (95% CI = 0.70-0.87). But there was lower predictability value, that is, the positive likelihood ratio was only 3.26 (95% CI 1.74-6.12) and the negative likelihood ratio was 0.32 (95% CI = 0.20-0.5). The diagnostic odds ratio was 12.40 (95% CI = 4.66-33.0). Conclusion. Increased serum S100B level at 24 hours of postnatal life can demonstrate brain damage, but it should not be the only one used to predict PA outcome.

scholarly journals Study of urinary uric acid and creatinine ratio as a marker of neonatal asphyxia for babies born in a tertiary care hospital

2017 ◽  
Vol 5 (12) ◽  
pp. 5418 ◽  
Author(s):  
Elango Krishnana ◽  
Venmugil Ponnusamy ◽  
Sathiya Priya Sekar
Keyword(s):  
Uric Acid ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Cerebral Injury ◽  
Care Hospital ◽  
Creatinine Ratio ◽  
Spot Urine ◽  
Medical College ◽  
Non Invasive

Background: Perinatal asphyxia is a common neonatal problem and there is significant contribution to neonatal morbidity and mortality. It is regarded as an important and common cause of preventable cerebral injury. The prediction of perinatal asphyxial outcome is important but formidable. There is only a limited role for the Apgar score for predicting the immediate outcome, such as HIE and the long-term neurological sequelae observational error can happen in APGAR. But biochemical parameters can be truly relied upon. This study was to evaluate the utility of urinary uric acid to creatinine ratio (UA/CR ratio) as non-invasive, easy, cheap and at the same time early biochemical means of asphyxia diagnosis.Methods: In this prospective case control study conducted in KAPV Government medical college between Feb 2017 to Sept 2017, 100 asphyxiated and 100 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for uric acid and creatinine estimation. Results were recorded, and statistical analysis was done.Results: The mean Uric acid/Creatinine ratio in the cases and controls groups were 2.58±1.09 and 0.86±0.17 respectively. The ratio also correlated well with the stage of HIE.Conclusions: The ratio of UA/Cr enables early and rapid recognition of asphyxial injury and also the assessment of its severity and the potential for short term morbidity or death.

scholarly journals Incidence and Outcomes of Acute Lung Injury in Patients With Isolated Traumatic Brain Injury

2021 ◽  
Vol 7 (3) ◽  
pp. 139-146
Author(s):  
Siamak Rimaz ◽  
◽  
Seyyed Mahdi Zia Ziabari ◽  
Neshat Jabbari ◽  
Zahra Pourmohammadi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Acute Lung Injury ◽  
Brain Injury ◽  
Lung Injury ◽  
Brain Damage ◽  
Study Data ◽  
Cerebral Injury ◽  
Age Group ◽  
Cross Sectional ◽  
Motorcycle Accident

Background and Aim: Traumatic Brain Injury (TBI) is an essential cause of morbidity and mortality worldwide. TBI patients frequently encounter lung complications, such as Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS), which is associated with poor clinical outcome because hypoxia causes additional injury to the brain. This study aimed to evaluate the frequency of ALI in patients with TBI and its consequences. Methods and Materials/Patients: In this descriptive cross-sectional study, data from all records of patients admitted to Poursina Hospital’s ICU (emergency and neurosurgery ICU) in 20 18-2019 were used. The evaluated data included age, gender, type of head trauma mechanism, kind of brain injury based on CT scan findings, the severity of brain injury based on Glasgow Coma Scale (GCS), underlying diseases, mean head AIS score, the number of pack cell units injected, as well as bilateral pulmonary infiltration in favor of ALI and brain injury. Results: Only 81 of the 557 TBI cases met the inclusion criteria of the present study. The highest frequency of ALI following TBI was observed on the first day of hospitalization, in men (0.41%) in the age group of 40-50 years (7%) with severe brain damage (6%) and subdural hematoma (12%), following a motorcycle accident, cars, as well as on the third day of hospitalization were seen in men (43.8%) with the age group of 20-30 years (55%) with severe brain damage (42%) and intra-parenchymal bleeding (57%), following a motorcycle accident. In addition, no significant correlation was detected between the incidence of ALI and mortality, the duration of hospitalization, GCS, mean head AIS score, or the extent of received blood units in our study. Conclusion: According to the obtained findings, men aged between 20 and 30 years with severe cerebral injury, epidural hematoma and a motorcycle accident presented the highest rate of progression toward ALI in the first to third days of hospitalization.

scholarly journals A. Taylor and Ch. Beling. Spastic paraplegia caused by brain damage. А case of spastic paraplegia following cerebral injury.—Journal of Nervous and Ment. Diseases, 1910, № 8

2021 ◽  
Vol XVIII (2) ◽  
pp. 504-504
Author(s):  
Vitaliy N. Likhnitsky
Keyword(s):  
Brain Damage ◽  
Cerebral Injury ◽  
Spastic Paraplegia ◽  
Cranial Cavity ◽  
The Right

A 19-year-old subject was hit in the right eye by a bullet and entered the cranial cavity and remained there.

scholarly journals Urinary uric acid or urinary creatinine ratio as a non-invasive marker for perinatal asphyxia

2020 ◽  
Vol 7 (6) ◽  
pp. 1378
Author(s):  
Siddharth . ◽  
Preeti Lata Rai ◽  
P. L. Prasad
Keyword(s):  
Uric Acid ◽  
Early Recognition ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Cerebral Injury ◽  
Creatinine Ratio ◽  
Urinary Creatinine ◽  
Spot Urine ◽  
Non Invasive

Background: Perinatal asphyxia is amongst the common problem of neonates and there exists a significant contribution to the neonatal morbidity and mortality. It is observed as a common and a vital cause of the preventable cerebral injury. The prediction of the perinatal asphyxial outcome is very important but dreadful. There is a limited role for APGAR score to predict the immediate outcome, like HIE and the long-term neurological sequelae observational error may happen in APGAR. But the biochemical parameters can truly be relied upon. This study was done to assess urinary uric acid/urinary creatinine ratio (UA/Cr) as a non-invasive marker for perinatal asphyxia and co-relate its absolute value to the degree of the perinatal asphyxia.Methods: In this prospective case control study conducted in the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences between Nov 2017 to May 2019, 42 asphyxiated and 42 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for the uric acid and creatinine estimation. Results were documented, and statistical analysis was performed.Results: Urinary uric acid to creatinine ratio used as additional non-invasive, early and easy biochemical marker of the birth asphyxia that biochemically supports severity grading and clinical diagnosis of the asphyxia by APGAR score.Conclusions: The ratio of the urinary uric acid and creatinine enables rapid and early recognition of asphyxial injury and also the evaluation of its severity and potential for short-term morbidity or death.

scholarly journals Selective head cooling and whole body cooling as neuroprotective agents in severe perinatal asphyxia

2019 ◽  
Vol 65 (8) ◽  
pp. 1116-1121 ◽  
Author(s):  
Mahara Nonato ◽  
Larissa Gheler ◽  
João Vitor Balestrieri ◽  
Marise Audi ◽  
Mirto Prandini
Keyword(s):  
Perinatal Asphyxia ◽  
Brain Structures ◽  
Brain Parenchyma ◽  
Cerebral Injury ◽  
Whole Body ◽  
Cortical Region ◽  
Head Cooling ◽  
Body Cooling ◽  
The Brain ◽  
Full Body

SUMMARY INTRODUCTION The possibility that hypothermia has a therapeutic role during or after resuscitation from severe perinatal asphyxia has been a longstanding focus of research. Studies designed around this fact have shown that moderate cerebral hypothermia, initiated as early as possible, has been associated with potent, long-lasting neuroprotection in perinatal patients. OBJECTIVES To review the benefits of hypothermia in improving cellular function, based on the cellular characteristics of hypoxic-ischemic cerebral injury and compare the results of two different methods of cooling the brain parenchyma. METHODS Medline, Lilacs, Scielo, and PubMed were searched for articles registered between 1990 and 2019 in Portuguese and English, focused on trials comparing the safety and effectiveness of total body cooling with selective head cooling with HIE. RESULTS We found that full-body cooling provides homogenous cooling to all brain structures, including the peripheral and central regions of the brain. Selective head cooling provides a more extensive cooling to the cortical region of the brain than to the central structures. CONCLUSIONS Both methods demonstrated to have neuroprotective properties, although full-body cooling provides a broader area of protection. Recently, head cooling combined with some body cooling has been applied, which is the most promising approach. The challenge for the future is to find ways of improving the effectiveness of the treatment.

scholarly journals A study on clinical correlation of EEG in neonates with perinatal asphyxia

2019 ◽  
Vol 6 (2) ◽  
pp. 390
Author(s):  
Rajendra Shinde ◽  
Kiran Haridas ◽  
Madhavi Shelke ◽  
L. S. Deshmukh ◽  
P. S. Patil
Keyword(s):  
Prospective Observational Study ◽  
Neonatal Period ◽  
Background Activity ◽  
Perinatal Asphyxia ◽  
Cerebral Injury ◽  
Eeg Analysis ◽  
Clinical Correlation ◽  
Term Neonates ◽  
Duration Of Hospitalization ◽  
Eeg Changes

Background: Perinatal asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. The WHO has estimated that 4 million babies die during the neonatal period every year. According to WHO, perinatal asphyxia is defined as the failure to initiate and sustain breathing at birth. The objective is to study the electroencephalographic changes and correlation between severity of Perinatal asphyxia with EEG changes.Methods: It is prospective observational study, which includes 40 term neonates admitted in NICU with perinatal asphyxia in GMCH Aurangabad. EEG analysis focused on background activity and classified into four categories.Results: The EEG was normal in 45%, mild abnormal in 25%, intermediate in 15%, and severely abnormal in 15%.  Outcome at discharge was normal in 19(47.5%) and abnormal in 21(52.5%) including 1 death. Abnormal outcome was seen in 27% of newborns with normal EEG and 72% of abnormal EEG.Conclusions: Severity of perinatal asphyxia correlated well with abnormality of EEG. EEG changes and severity showed good correlation with immediate outcome of newborn in terms of duration of hospitalization and normal neurological examination.

PERINATAL ASPHYXIA AND PSYCHOLOGIC SIGNS OF BRAIN DAMAGE IN CHILDHOOD

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 1016-1025
Author(s):  
Frances F. Schachter ◽  
Virginia Apgar
Keyword(s):  
Brain Damage ◽  
Oxygen Content ◽  
Perinatal Asphyxia ◽  
Experimental Tests ◽  
Past Research ◽  
Future Research ◽  
Perinatal Complications ◽  
Clinical Criteria ◽  
Iq Test ◽  
Neonatal Blood

A prospective study on the psychologic effects of perinatal asphyxia is reported. It is the second report of follow-up studies of a sample of newborns selected at random from an obstetrical ward service in New York City. The first study showed no effect of early asphyxia as measured by oxygen content of heel blood in the neonatal period. Further investigation seemed indicated, using more extensive measures both of early asphyxia and psychologic effects. In the present study, early asphyxia was defined by perinatal complications and by level of oxygen content in neonatal blood. Psychologic evaluation included 23 diagnostic signs of brain damage based on an IQ test, special experimental tests of brain damage, school report cards, and behavior ratings. Children with perinatal complications showed a statistically significant decrement on the IQ test and on three special tests of brain damage: the Bender-Gestalt, Sorting test, and Critical Flicker Frequency. However, the clinical significance of these positive findings must be viewed with caution in the light of the relatively small mean decrement of 4.87 points in IQ and the negative findings on the remaining special tests of brain damage. A discussion of the conflicting results of the present and past research yielded suggestions for refinements in the clinical criteria of perinatal asphyxia, the psychologic instruments, and the selection of experimental controls. While statistically significant relationships were demonstrated between multiple clinical criteria of perinatal asphyxia and several psychologic signs of brain damage in childhood, no such relationships were shown for the measurements of oxygen content in neonatal blood. The limitations of measurement of oxygen content are discussed together with suggestions for future research.

scholarly journals Immunomodulatory Mechanism and Potential Therapies for Perinatal Hypoxic-Ischemic Brain Damage

2020 ◽  
Vol 11 ◽  
Author(s):  
Ying-Jun Min ◽  
Eng-Ang Ling ◽  
Fan Li
Keyword(s):  
Brain Damage ◽  
Cell Activation ◽  
Brain Injuries ◽  
Immune Cell ◽  
Perinatal Asphyxia ◽  
Therapeutic Agents ◽  
Neurological Dysfunction ◽  
Ischemic Brain Damage ◽  
Ischemic Brain ◽  
The Many

Hypoxia-ischemia (HI) is one of the most common causes of death and disability in neonates. Currently, the only available licensed treatment for perinatal HI is hypothermia. However, it alone is not sufficient to prevent the brain injuries and/or neurological dysfunction related to HI. Perinatal HI can activate the immune system and trigger the peripheral and central responses which involve the immune cell activation, increase in production of immune mediators and release of reactive oxygen species. There is mounting evidence indicating that regulation of immune response can effectively rescue the outcomes of brain injury in experimental perinatal HI models such as Rice-Vannucci model of newborn hypoxic-ischemic brain damage (HIBD), local transient cerebral ischemia and reperfusion model, perinatal asphyxia model, and intrauterine hypoxia model. This review summarizes the many studies about immunomodulatory mechanisms and therapies for HI. It highlights the important actions of some widely documented therapeutic agents for effective intervening of HI related brain damage, namely, HIBD, such as EPO, FTY720, Minocycline, Gastrodin, Breviscapine, Milkvetch etc. In this connection, it has been reported that the ameboid microglial cells featured prominently in the perinatal brain represent the key immune cells involved in HIBD. To this end, drugs, chemical agents and herbal compounds which have the properties to suppress microglia activation have recently been extensively explored and identified as potential therapeutic agents or strategies for amelioration of neonatal HIBD.

scholarly journals Biochemical Markers in Perinatal Asphyxia

2011 ◽  
Vol 31 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Manisha Naithani ◽  
Ashish Kumar Simalti
Keyword(s):  
Creatine Kinase ◽  
Uric Acid ◽  
Biochemical Markers ◽  
Perinatal Asphyxia ◽  
Elevated Serum ◽  
Neuron Specific Enolase ◽  
Protein S ◽  
Cerebral Injury ◽  
Early Assessment ◽  
Therapeutic Decisions

Early assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated. Key words: S-100; Brain specific creatine kinase; neuron specific enolase; IL6; urinary uric acid; hypoxic ischaemic cerebral injury. DOI: 10.3126/jnps.v31i2.4155 J Nep Paedtr Soc 2010;31(2):151-156

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