Perinatal hypoxic—Ischemic thalamic injury: Clinical features and neuroimaging

Roland, Elke H.; Poskitt, Kenneth J.; Rodríguez, Encarnación; Lupton, Brian A.; Hill, Alan

doi:10.1002/ana.410440205

Cited by 160 publications

(90 citation statements)

References 12 publications

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“…7,8 Prolonged partial asphyxia results in a pattern of injury that primarily involves the watershed zones between the major intravascular boundary zones, whereas acute profound asphyxia results in the basal ganglia-predominant pattern of brain injury that involves the basal ganglia, thalami, brain stem, sensorimotor cortex, and corticospinal tracts. 1,18,19 Severe watershed and basal ganglia-predominant patterns of injury can manifest as total brain injury, occurring when both the cerebral cortex and deep gray nuclei are hypoperfused. 18 Multifocal predominant pattern of injury describes injury seen in the white matter or cortex.…”

Section: Discussionmentioning

confidence: 99%

Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy

Wong¹,

Poskitt

Chau³

et al. 2013

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy

Wong¹,

Poskitt

Chau³

et al. 2013

AJNR Am J Neuroradiol

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“…3) (Barkovich et al 1998;Sie et al 2000). These patterns in the human newborn are associated with different antenatal risk factors and neurodevelopmental outcomes (Miller et al 2005b;Roland et al 1998). In fact, the pattern of brain injury on MRI is even more predictive of neurodevelopmental outcome than the severity of the lesions (Cowan et al 2003;Miller et al 2005b).…”

Section: Brain Injury Patterns In the Termmentioning

confidence: 99%

Imaging selective vulnerability in the developing nervous system

Ferriero

Miller

2010

Journal of Anatomy

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Why do cells in the central nervous system respond differently to different stressors and why is this response so age-dependent? In the immature brain, there are regions of selective vulnerability that are predictable and depend on the age when the insult occurs and the severity of the insult. This damage is both region and cell population specific. Vulnerable cell populations include the subplate neurons and oligodendrocyte precursors early in development and the neurons closer to the end of human gestation. Mechanisms of injury include excitotoxicity, oxidative stress and inflammation as well as accelerated apoptosis. Advanced imaging techniques have shown us particular patterns of injury according to age at insult. These changes seen in the newborn at the time of injury on magnetic resonance imaging correlate well with the neurodevelopmental outcome. New questions about how the injury evolves and how the newborn brain adapts and repairs itself have emerged as we now know that injury in the newborn brain can evolve over days and weeks, rather than hours. The ability to follow these processes has allowed us to investigate the role of repair in attenuating the injury. Neurogenesis and angiogenesis exist in response to ischemic injury and can be enhanced by processes that are known to protect the brain. The injury response in the developing brain is a complex process that evolves over time and is amenable to repair.

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“…(10) It has been widely accepted that the risk of an abnormal neurodevelopmental outcome increases with the severity of brain injury. (11,12) However, the pattern of injury may be even more predictive than the severity of lesions shown on MRI. The basalganglia/thalamus pattern has been associated with severely impaired motor and cognitive outcomes (2, 7) and the watershed-predominant pattern with cognitive impairments that often occur in the absence of functional motor deficits.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Neurodevelopmental Outcome with Hypoxic-Ischemic Encephalopathy

Perez

Ritter

Brotschi

et al. 2013

The Journal of Pediatrics

120

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OBJECTIVES: To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits. STUDY DESIGN: Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or mental retardation). Brain injury was scored according to the region and extent of injury. RESULTS: Children without major disability (n = 57) had lower full-scale and performance IQ scores compared with norms (P = .02 and .01, respectively), and the proportion of children with an IQ <85 was higher than expected (P = .04). Motor performance on the Zurich Neuromotor Assessment was affected in the pure motor, adaptive fine motor, and gross motor domains, as well as in the movement quality domain (all P < .001). Watershed injury pattern on neonatal MRI correlated with full-scale and verbal IQ scores (P = .006 and <.001, respectively), but neonatal MRI pattern did not correlate with motor performance in children without major disability. CONCLUSION: Children who sustained neonatal HIE without major disability are at increased risk for long-term intellectual, verbal, and motor deficits. The severity of watershed injury is correlated with later intellectual performance. Long-term follow-up examinations are necessary for early detection of neurodevelopmental impairment and early initiation of adequate therapies. AbstractObjectives: To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy without major disability and to examine the role of neonatal cerebral MRI injury patterns in relation to later deficits.Study design: Sixty-eight prospectively enrolled children with hypoxic-ischemic encephalopathy and neonatal cerebral MRI were examined at a mean age of 11.2 years (range 8.2 -15.7 years). Eleven children had a major disability (cerebral palsy or mental retardation). Brain injury was scored according to region and extent of injury.Results: Children without major disability (n=57) had lower total and performance IQ scores compared to the norm (p=0.02 and 0.01, respectively) and the proportion of children with an IQ < 85 was higher than that expected (p= 0.04). Motor performance on the Zurich Neuromotor Assessment was affected in the domains 'pure motor', 'adaptive fine' and 'gross motor' as well as in the domain 'movement quality' (all p-values< 0.001). Watershed injury pattern on neonatal MRI correlated with total and verbal IQ (p=0.006 and < 0.001, respectively), while neonatal MRI pattern did not correlated with motor performance in children without major disability. Conclusions:Children after neonatal hypoxic-ischemic encephalopathy without major disability are at higher risk for long-term intellectual, verbal and motor deficits. Severity of watershed injury correlates ...

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Perinatal hypoxic—Ischemic thalamic injury: Clinical features and neuroimaging

Cited by 160 publications

References 12 publications

Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy

Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy

Imaging selective vulnerability in the developing nervous system

Long-Term Neurodevelopmental Outcome with Hypoxic-Ischemic Encephalopathy

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