Document Detail


Seizures, hypoxic-ischemic brain injury, and intraventricular hemorrhage in the newborn.
MedLine Citation:
PMID:  7283398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The review deals with neonatal seizures, perinatal hypoxic-ischemic brain injury, and neonatal intraventricular hemorrhage. neonatal seizures are the most prominent signals of the largest number of neonatal neurological disorders. The convulsive phenomena may be subtle. The predominant etiological process is hypoxic-ischemic encephalopathy. Prognosis is related primarily to the neurological disease responsible for the seizures. Treatment may be specific for the underlying disorder (e.g., glucose or calcium) or less specific (i.e., therapy with anticonvulsant drugs). Prompt control of the seizures is important to avoid brain injury secondary to the effects of the seizures on ventilation, perfusion, and brain metabolism. Hypoxic-ischemic encephalopathy in the newborn most often is a consequence of intrauterine asphyxia. Diagnosis depends primarily on recognition of the clinical syndrome but also on a variety of neurodiagnostic techniques, including radionuclide and CT brain scans. Prognosis is estimated best by a combination of clinical analysis and specialized neurodiagnostic studies. management is based principally on vigorous support, particularly of ventilation and perfusion, maintenance of adequate glucose influx, and control of seizures. Intraventricular hemorrhage is the most common type of neonatal intracranial hemorrhage. The neuropathology is characterized by bleeding from capillaries of the subependymal germinal matrix. Secondary rupture of the ependymal lining then causes intraventricular hemorrhage. Pathogenesis relates to the anatomy of the germinal matrix, the distribution and regulation of cerebral blood flow, and the structure and vulnerability of periventricular capillaries. Precise diagnosis requires a brain imaging procedure; portable, real-time ultrasound is the preferred approach for critically ill infants. Prognosis relates to the severity of the hemorrhage as well as any preceding hypoxic-ischemic insults and the subsequent occurrence of hydrocephalus. Choice of therapy for posthemorrhagic ventricular dilatation depends upon severity and rapidity of progression and ranges from close observation only to ventriculoperitoneal shunting.
Authors:
A Hill; J J Volpe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of neurology     Volume:  10     ISSN:  0364-5134     ISO Abbreviation:  Ann. Neurol.     Publication Date:  1981 Aug 
Date Detail:
Created Date:  1981-11-22     Completed Date:  1981-11-22     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  109-21     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Brain Ischemia / diagnosis
Cerebral Hemorrhage / diagnosis
Cerebrovascular Disorders / diagnosis*,  etiology,  therapy
Encephalomalacia / diagnosis
Female
Fetal Hypoxia / complications
Humans
Hypoxia, Brain / diagnosis
Infant, Newborn
Infant, Newborn, Diseases / diagnosis*,  etiology,  therapy
Pregnancy
Seizures / diagnosis*,  drug therapy,  etiology

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