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

Author(s):  
Mehmet Çoşkun ◽  
Oğuz Han Kalkanlı ◽  
Rüya Çolak ◽  
Senem Alkan Özdemir ◽  
Tülin Gökmen Yıldırım ◽  
...  

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.

2015 ◽  
Vol 5 (1) ◽  
pp. 27-35
Author(s):  
Z. Zimova ◽  
K. Matasova ◽  
M. Zibolen

Abstract Amplitude-integrated electroencephalography (aEEG) is a simplified bedside neurophysiology tool that has become widely used in neonates in the last few years. Although aEEG cannot replace conventional EEG (cEEG) for background monitoring and detection of seizures, it remains a useful apparatus that complements conventional EEG, is being widely adopted by neonatologists, and should be supported by neonatal neurologists. Limited channel leads are applied to the patient and data are displayed in a semilogarithmic, time-compressed scale. In term neonates, aEEG has been used to determine the prognosis and treatment for those affected by hypoxic-ischemic encephalopathy, seizures, meningitis and even congenital heart disease. In preterm infants, normative values and pattern corresponding to gestational age are being established. The senzitivity and specificity of aEEG are enhanced by the display of a simultaneous raw EEG.


2020 ◽  
Vol 7 (2) ◽  
pp. 47-49
Author(s):  
Dr. Kajalkumari Jain ◽  
Dr. Ramesh B. Kothari ◽  
Dr. Sunil Natha Mhaske ◽  
Dr. Ganesh B. Misal ◽  
Dr. Ujjwala Shirsath

Neonates born through meconium stained amniotic fluid,2-3% of them develop Meconium Aspiration Syndrome. Out of them,5-10% of them develop complications. Meconium Aspiration is typically seen in post-mature, small for date infants or a term infant with intrauterine hypoxia and in babies born with birth weight more than 2500gm.The objective is to study the complications of Meconium Aspiration Syndrome and their outcome in relation to gestational age and birth weight. Methodology: It is an prospective observational study was carried out in NICU of tertiary care centre and included 32 cases of Meconium aspiration syndrome. Study was done in a period of 14 months in and around Ahmednagar district. Result: The complications are Hypoxic Ischemic Encephalopathy (HIE), Seizures, Septicaemia, Pneumonia, Persistent Pulmonary Hypertension(PPHN), Airleak. Outcome of meconium aspiration syndrome in relation to gestational age is maximum death of 56.25% occurred in term babies which were 18.Outcome of meconium aspiration syndrome in relation to birth weight is maximum death of 53.12% occurred in neonates weighing between 2.5 to 3.5 kg which were 17. Conclusion: Meconium aspiration syndrome is seen in the new born period and contributes significantly to the neonatal morbidity and mortality. Severe Hypoxic ischemic encephalopathy being most common complication and birth asphyxia being most common cause of death.


PEDIATRICS ◽  
1974 ◽  
Vol 54 (6) ◽  
pp. 689-695
Author(s):  
Robert M. Shuman ◽  
Richard W. Leech ◽  
Ellsworth C. Alvord

To assess the susceptibility of human beings to the neurotoxic effects of hexachlorophene demonstrated in experimental animals, a blind clinicopathologic analysis was made of 248 children coming to autopsy over a 7.5-year period in the two Seattle institutions to which practically all premature or sick children are referred. Repeated whole-body bathing of premature newborn infants in 3% hexachlorophene-bearing soap (undiluted pHisoHex) is associated with a vacuolar encephalopathy of the brainstem reticular formation. The prevalence of the vacuolar encephalopathy appears to be related to the number of exposures to hexachlorophene, to the concentration of hexachiorophene, to the birth weight (gestational age), to the length of survival and to the thoroughness of rinsing. From these observations we conclude that hexachlorophene should not be used on neonates under 1,400 gm birth weight and should be used only sparingly in full-term neonates with thorough rinsing.


Author(s):  
Megan Elliott ◽  
Santina Zanelli ◽  
Karen Fairchild ◽  
Jennifer Burnsed ◽  
Kristen Heinan ◽  
...  

2019 ◽  
Vol 9 (3) ◽  
pp. 160-165
Author(s):  
Bithi Debnath ◽  
Naila Zaman Khan ◽  
Dilara Begum ◽  
Asma Begum Shilpi ◽  
Shaheen Akter

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


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