scholarly journals Is There a Way to Predict Outcome in (Near) Term Neonates with Hypoxic-Ischemic Encephalopathy Based on MR Imaging?

2008 ◽  
Vol 29 (9) ◽  
pp. 1789-1794 ◽  
Author(s):  
L. Liauw ◽  
J. van der Grond ◽  
A.A. van den Berg-Huysmans ◽  
L.A.E.M. Laan ◽  
M.A. van Buchem ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Neonates ◽  
Near Term ◽  
Ischemic Encephalopathy

scholarly journals Clinico-etiological profile of seizures in term and near-term neonates: tertiary care hospital based observational study

2017 ◽  
Vol 4 (6) ◽  
pp. 2200
Author(s):  
Garima Verma ◽  
Sumaiya Shamsi ◽  
Umesh Pathak
Keyword(s):  
Risk Factor ◽  
Observational Study ◽  
Neurological Outcome ◽  
Neonatal Period ◽  
Hypoxic Ischemic Encephalopathy ◽  
Term Neonates ◽  
Clinical Type ◽  
Poor Neurological Outcome ◽  
Near Term ◽  
Ischemic Encephalopathy

Background: Neonatal period is very important for development of immature brain and it is also most vulnerable period for development of seizures. Seizures have varied etiology as well as presentation during neonatal period. Considering this we planned this study with objective of finding incidence, etiology, type and time of onset of seizures and their correlation along with short term outcome.Methods: It is a prospective observational study done in level 2 NICU set up of Government Medical College from November 2008 to September 2009. Total 115 term and near term neonates (≥35 weeks of gestation) presenting in NICU with seizures were enrolled in study. All relevant details were recorded on performa and investigations were sent. Data was described as mean±SD and %. SPSS 13 software was used as data analysis.Results: Incidence of seizures came out to be 6.1% of total NICU admission, which was more in male appropriate for gestational age (AGA) babies and those who were born vaginally, extramural and to primiparous mother. Birth asphyxia was most common etiology of seizures and majority presented within 24 hours of birth and meningitis was most important cause of seizure after 7 days of life. Subtle seizures were most common clinical type of seizure in the present study. Risk factor for poor neurological outcome came out to be Hypoxic Ischemic Encephalopathy (HIE). Conclusions: Hypoxic ischemic encephalopathy was most important etiology of neonatal seizures and most important risk factor for poor neurological outcome and subtle seizures being most common clinical type of seizure. 

MRI IN HYPOXIC ISCHEMIC ENCEPHALOPATHY WITH CLINICAL FOLLOW UP

2021 ◽  
pp. 43-48
Author(s):  
M R Shashikumar ◽  
Narasipur Lingaiah Rajendrakumar ◽  
Sanjay P ◽  
Nanjaraj Chakenalli Puttaraj ◽  
Shruti Shruti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Mr Imaging ◽  
Developmental Disorders ◽  
Brain Mri ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Preterm Neonates ◽  
Diffusion Restriction ◽  
Ischemic Encephalopathy

Introduction: HIE is often clinically suspected in the setting of a known perinatal stress event arising from a complicated or difcult delivery. The most sensitive and specic imaging technique for examining infants with suspected hypoxicischemic brain injury is MR imaging. It also gives information about the timing and specic patterns of injury and also suggest diagnoses other than HIE such as metabolic disorders and developmental disorders of the brain. MRI is also a useful tool in the determination of prognosis and also follow-up of HIE. Aim: This study was undertaken to evaluate the various MRI appearances of hypoxic ischemic encephalopathy in term and preterm neonates and to correlate the MRI appearances with clinical outcome. Materials and Methods: All neonates with history of birth asphyxia, referred for MRI examination to the Department of Radio-Diagnosis, K. R. Hospital attached to Mysore Medical College and Research Institute, during January 2018 to January 2019. All MRI scans were performed on GE optima MR360 1.5 Tesla. Sequences used were T1W axial, T1 FLAIR axial, T2W axial, T2 FLAIR axial, T1W sag, T2W coronal, T2W GRE axial, DWI axial and ADC maps. Results: 30 babies with clinically suspicion of HIE and positive ndings on MR imaging were evaluated in our study. Out of 30 babies, 18 were term and 12 babies were preterm. Periventricular luecomalacia is most common MRI pattern in preterm and central pattern in term neonates. 16 babies had abnormal developmental outcome at 6 months follow up study. 16 babies with diffusion restriction in corpus callosum, 12 had abnormal outcome. 7 out of 10 babies with loss of normal signal in internal capsule had abnormal outcome. Babies with diffusion restriction in basal ganglia had gross developmental delay. Conclusion: MRI is the modality of choice for evaluation of HIE because of excellent gray – white matter resolution, well-depiction of myelination pattern and multi-planar imaging capabilities. There is a strong relation between the MRI appearances of birth asphyxia and the clinical outcome. Therefore MRI has a strong role in prognosticating lesions.

scholarly journals Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

2019 ◽  
Vol 9 (3) ◽  
pp. 160-165
Author(s):  
Bithi Debnath ◽  
Naila Zaman Khan ◽  
Dilara Begum ◽  
Asma Begum Shilpi ◽  
Shaheen Akter
Keyword(s):  
Elevated Temperature ◽  
Rectal Temperature ◽  
Neurodevelopmental Outcome ◽  
Hypoxic Ischemic Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Term Neonates ◽  
Risk Of Death ◽  
The Mean ◽  
Ischemic Encephalopathy

Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy. Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth. Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender. Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50). Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes. J Enam Med Col 2019; 9(3): 160-165

scholarly journals Cranial MRI Findings in Predicting the Severity of Hypoxic-Ischemic Encephalopathy in Term Neonates

2021 ◽  
Author(s):  
Mehmet Çoşkun ◽  
Oğuz Han Kalkanlı ◽  
Rüya Çolak ◽  
Senem Alkan Özdemir ◽  
Tülin Gökmen Yıldırım ◽  
...  
Keyword(s):  
Birth Weight ◽  
Globus Pallidus ◽  
Gestational Age ◽  
Hypoxic Ischemic Encephalopathy ◽  
Mri Findings ◽  
Term Neonates ◽  
Signal Abnormality ◽  
Cranial Mri ◽  
Ischemic Encephalopathy ◽  
Signal Intensities

Objective: The aim of this study is to compare magnetic resonance imaging (MRI) findings with severity of hypoxic-ischemic encephalopathy (HIE) in term neonates. Methods: Sixty-three newborns with HIE in whom cranial MRIs were performed within the first 3 weeks of life between 2016 and 2020 were included in the study. Severity of HIE was graded using Sarnat & Sarnat staging. In statistical analysis, Stage 1 was considered as mild, Stage 2 or 3 as severe HIE. The signal intensities of perirolandic cortex, posterior limb of internal capsule (PLIC), globus pallidus, and cerebrospinal tract on T1- weighted imaging (T1WI), and of perirolandic cortex, PLIC, ventrolateral thalamus, lateral edge of putamen and tegmentum on T2WI, and brain diffusion weighted imaging (DWI) findings were evaluated with consensus by two radiologists blinded to clinical findings. Gestational age, birth weight and MRI signal intensities were compared with HIE groups using t test, and Fisher-Exact test. Results: There were 31 and 32 infants with mild and severe HIE, respectively. Gestational age and birth weight were not different between mild and severe HIE groups. The number of cases with abnormal signals in PLIC and globus pallidus on T1WI, and PLIC on T2WI were significantly higher in severe HIE (p=0.022, p=0.008, and p=0.032, respectively). The presence of signal abnormality in other regions and DWI were not significantly different between HIE groups. Conclusion: Cranial MRI may play a remarkable role in determining pattern and severity of HIE. Signal abnormality in PLIC and globus pallidus may suggest severe HIE in term neonates.

scholarly journals Dexmedetomidine for Sedation of Neonates with HIE Undergoing Therapeutic Hypothermia: A Single-Center Experience

2018 ◽  
Vol 08 (03) ◽  
pp. e168-e173 ◽  
Author(s):  
Keliana O'Mara ◽  
Michael Weiss
Keyword(s):  
Therapeutic Hypothermia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Limited Data ◽  
Single Center ◽  
Short Term ◽  
Term Neonates ◽  
Risk Of Death ◽  
Single Center Experience ◽  
Dexmedetomidine Infusion ◽  
Ischemic Encephalopathy

AbstractHypoxic-ischemic encephalopathy (HIE) is a significant cause of morbidity and mortality in neonates. Therapeutic hypothermia reduces the risk of death or disability. Providing optimal sedation while neonates are undergoing therapeutic hypothermia is likely beneficial but may present therapeutic challenges. There are limited data describing the use of dexmedetomidine for sedation in patients undergoing therapeutic hypothermia. The objective of this study is to evaluate the efficacy and short-term safety of dexmedetomidine infusion for sedation in term neonates undergoing therapeutic hypothermia for HIE.

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