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Magnetic resonance imaging spectrum of perinatal hypoxic-ischemic brain injury

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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.


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A 6-day-old term neonate, with history of perinatal depression. Axial T2 (A) and Axial T1 (B) WI show parenchymal subacute hematoma (H) in the right frontal lobe with mass effect. Also note subacute SDH in the right frontal region and anterior interhemispheric fissure (arrow)
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Figure 19: A 6-day-old term neonate, with history of perinatal depression. Axial T2 (A) and Axial T1 (B) WI show parenchymal subacute hematoma (H) in the right frontal lobe with mass effect. Also note subacute SDH in the right frontal region and anterior interhemispheric fissure (arrow)

Mentions: PHS was coined by Armstrong-Wells et al.[19] and included intracerebral hemorrhage or subarachnoid hemorrhage, excluding pure GM-IVH. They found a population prevalence of 6.2 in 100,000 live births for PHS. However, some overlap exists between these conditions due to hemorrhagic transformation of PAIS and venous infarcts [Figure 19].


Magnetic resonance imaging spectrum of perinatal hypoxic-ischemic brain injury
A 6-day-old term neonate, with history of perinatal depression. Axial T2 (A) and Axial T1 (B) WI show parenchymal subacute hematoma (H) in the right frontal lobe with mass effect. Also note subacute SDH in the right frontal region and anterior interhemispheric fissure (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5036328&req=5

Figure 19: A 6-day-old term neonate, with history of perinatal depression. Axial T2 (A) and Axial T1 (B) WI show parenchymal subacute hematoma (H) in the right frontal lobe with mass effect. Also note subacute SDH in the right frontal region and anterior interhemispheric fissure (arrow)
Mentions: PHS was coined by Armstrong-Wells et al.[19] and included intracerebral hemorrhage or subarachnoid hemorrhage, excluding pure GM-IVH. They found a population prevalence of 6.2 in 100,000 live births for PHS. However, some overlap exists between these conditions due to hemorrhagic transformation of PAIS and venous infarcts [Figure 19].

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