Document Detail

Perinatal hypoxic-ischemic thalamic injury: clinical features and neuroimaging.
MedLine Citation:
PMID:  9708537     Owner:  NLM     Status:  MEDLINE    
A common pattern of hypoxic-ischemic cerebral injury in the term newborn involves predominantly cerebral cortex and subcortical white matter. We describe 20 term newborns with moderate or severe acute hypoxic-ischemic encephalopathy who exhibit a different pattern of abnormalities on computed tomography, with evidence of decreased tissue attenuation predominantly in thalami and basal ganglia and relative preservation of cerebral cortex and white matter. Profound, acute hypoxic-ischemic insult (eg, umbilical cord prolapse, uterine rupture, or massive placental abruption) was documented in 16 of 20 infants (80%). Characteristic clinical features during the newborn period included irritability, tonic posturing of limbs, and persistent lower cranial nerve dysfunction, often with prominent tongue fasciculations. This pattern of central injury appears to be highly predictive of poor outcome; 7 newborns (35%) died, and all survivors who had follow-up to 18 months of age (11) had major neurological sequelae (eg, spastic quadriplegia, choreoathetosis, and persistent feeding problems). This pattern of hypoxic-ischemic cerebral injury corresponds closely to experimental animal models of "acute total" perinatal asphyxia.
E H Roland; K Poskitt; E Rodriguez; B A Lupton; A Hill
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of neurology     Volume:  44     ISSN:  0364-5134     ISO Abbreviation:  Ann. Neurol.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-08-25     Completed Date:  1998-08-25     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  161-6     Citation Subset:  IM    
Division of Neurology, University of British Columbia, British Columbia's Children's Hospital, Vancouver, Canada.
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MeSH Terms
Apgar Score
Basal Ganglia / radiography
Brain Damage, Chronic / congenital*,  diagnosis*,  mortality,  therapy
Diagnostic Techniques, Neurological
Fetal Hypoxia / complications*
Follow-Up Studies
Infant, Newborn
Ischemic Attack, Transient / complications,  diagnosis*,  mortality
Magnetic Resonance Imaging
Observer Variation
Predictive Value of Tests
Pregnancy Outcome
Putamen / pathology
Survival Rate
Thalamic Diseases / congenital*,  diagnosis*,  mortality
Thalamus / pathology,  radiography
Tomography, X-Ray Computed*
Comment In:
Ann Neurol. 1998 Aug;44(2):155-6   [PMID:  9708534 ]

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