Limits...
Magnetic resonance imaging spectrum of perinatal hypoxic-ischemic brain injury

View Article: PubMed Central - PubMed

ABSTRACT

Perinatal hypoxic–ischemic brain injury results in neonatal hypoxic–ischemic encephalopathy and serious long-term neurodevelopmental sequelae. Magnetic resonance imaging (MRI) of the brain is an ideal and safe imaging modality for suspected hypoxic–ischemic injury. The pattern of injury depends on brain maturity at the time of insult, severity of hypotension, and duration of insult. Time of imaging after the insult influences the imaging findings. Mild to moderate hypoperfusion results in germinal matrix hemorrhages and periventricular leukomalacia in preterm neonates and parasagittal watershed territory infarcts in full-term neonates. Severe insult preferentially damages the deep gray matter in both term and preterm infants. However, associated frequent perirolandic injury is seen in term neonates. MRI is useful in establishing the clinical diagnosis, assessing the severity of injury, and thereby prognosticating the outcome. Familiarity with imaging spectrum and insight into factors affecting the injury will enlighten the radiologist to provide an appropriate diagnosis.

No MeSH data available.


Related in: MedlinePlus

A 10-day-old full-term neonate with perinatal left middle cerebral artery territory infarction. (A, B) Axial T1WI at and above the level of lateral ventricles show T1 hypointense (edema) and hyperintense (astrogliosis) areas involving left the middle cerebral artery (MCA) territory. No blooming in the gradient images rules out haemorrhage. (C, D) Axial T2 and FLAIR images at the level of lateral ventricles show predominant T2 hyperintensity and few hypointense areas involving the left MCA territory. No blooming in the gradient images rules out hemorrhage. (E-G) Axial DWI at the level of lateral ventricles, midbrain and pons show diffusion restriction involving left corticospinal tract
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5036328&req=5

Figure 18: A 10-day-old full-term neonate with perinatal left middle cerebral artery territory infarction. (A, B) Axial T1WI at and above the level of lateral ventricles show T1 hypointense (edema) and hyperintense (astrogliosis) areas involving left the middle cerebral artery (MCA) territory. No blooming in the gradient images rules out haemorrhage. (C, D) Axial T2 and FLAIR images at the level of lateral ventricles show predominant T2 hyperintensity and few hypointense areas involving the left MCA territory. No blooming in the gradient images rules out hemorrhage. (E-G) Axial DWI at the level of lateral ventricles, midbrain and pons show diffusion restriction involving left corticospinal tract

Mentions: Perinatal stroke comprises perinatal arterial ischemic stroke (PAIS), perinatal hemorrhagic stroke (PHS), and sinovenous thrombosis. PAIS is defined as cerebrovascular accident occurring between 28 weeks of gestational age and 28 days after delivery, with radiological or pathological evidence of focal arterial infarction.[17] The incidence of perinatal arterial ischemic stroke recognized during neonatal period was 1 in 2300 in term infants.[18] The most common type of PAIS is ischemic lesions involving the middle cerebral artery [Figure 18). DWI has the highest sensitivity at acute phase and also detects prewallerian degeneration of the corticospinal tract (Figure 18E and F).


Magnetic resonance imaging spectrum of perinatal hypoxic-ischemic brain injury
A 10-day-old full-term neonate with perinatal left middle cerebral artery territory infarction. (A, B) Axial T1WI at and above the level of lateral ventricles show T1 hypointense (edema) and hyperintense (astrogliosis) areas involving left the middle cerebral artery (MCA) territory. No blooming in the gradient images rules out haemorrhage. (C, D) Axial T2 and FLAIR images at the level of lateral ventricles show predominant T2 hyperintensity and few hypointense areas involving the left MCA territory. No blooming in the gradient images rules out hemorrhage. (E-G) Axial DWI at the level of lateral ventricles, midbrain and pons show diffusion restriction involving left corticospinal tract
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036328&req=5

Figure 18: A 10-day-old full-term neonate with perinatal left middle cerebral artery territory infarction. (A, B) Axial T1WI at and above the level of lateral ventricles show T1 hypointense (edema) and hyperintense (astrogliosis) areas involving left the middle cerebral artery (MCA) territory. No blooming in the gradient images rules out haemorrhage. (C, D) Axial T2 and FLAIR images at the level of lateral ventricles show predominant T2 hyperintensity and few hypointense areas involving the left MCA territory. No blooming in the gradient images rules out hemorrhage. (E-G) Axial DWI at the level of lateral ventricles, midbrain and pons show diffusion restriction involving left corticospinal tract
Mentions: Perinatal stroke comprises perinatal arterial ischemic stroke (PAIS), perinatal hemorrhagic stroke (PHS), and sinovenous thrombosis. PAIS is defined as cerebrovascular accident occurring between 28 weeks of gestational age and 28 days after delivery, with radiological or pathological evidence of focal arterial infarction.[17] The incidence of perinatal arterial ischemic stroke recognized during neonatal period was 1 in 2300 in term infants.[18] The most common type of PAIS is ischemic lesions involving the middle cerebral artery [Figure 18). DWI has the highest sensitivity at acute phase and also detects prewallerian degeneration of the corticospinal tract (Figure 18E and F).

View Article: PubMed Central - PubMed

ABSTRACT

Perinatal hypoxic–ischemic brain injury results in neonatal hypoxic–ischemic encephalopathy and serious long-term neurodevelopmental sequelae. Magnetic resonance imaging (MRI) of the brain is an ideal and safe imaging modality for suspected hypoxic–ischemic injury. The pattern of injury depends on brain maturity at the time of insult, severity of hypotension, and duration of insult. Time of imaging after the insult influences the imaging findings. Mild to moderate hypoperfusion results in germinal matrix hemorrhages and periventricular leukomalacia in preterm neonates and parasagittal watershed territory infarcts in full-term neonates. Severe insult preferentially damages the deep gray matter in both term and preterm infants. However, associated frequent perirolandic injury is seen in term neonates. MRI is useful in establishing the clinical diagnosis, assessing the severity of injury, and thereby prognosticating the outcome. Familiarity with imaging spectrum and insight into factors affecting the injury will enlighten the radiologist to provide an appropriate diagnosis.

No MeSH data available.


Related in: MedlinePlus