Document Detail


White matter and cortical injury in hypoxic-ischemic encephalopathy: antecedent factors and 2-year outcome.
MedLine Citation:
PMID:  22682614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the spectrum of isolated white matter (WM)/cortical injury and its relation to outcomes in infants with hypoxic-ischemic encephalopathy (HIE) and normal appearing basal ganglia and thalami.
STUDY DESIGN: From 1992-2007, 84 term infants with HIE and normal basal ganglia and thalami on neonatal magnetic resonance imaging were studied; WM/cortical lesions were classified by site and severity. Neurodevelopmental outcomes and head growth were documented at a median age of 2 years.
RESULTS: The WM was normal or mildly abnormal in 33.5%, moderate in 40.5%, and severely abnormal in 26% of infants. Cortical involvement was not seen or was only mild in 75.5%, moderate in 13%, and severe in 12% of infants. WM and cortical injury severity were highly correlated (Spearman ρ = 0.74; P < .001). Infants with severe WM injury had more severe neonatal courses and a higher incidence of hypoglycemia. No infant died. Five infants (6%) developed cerebral palsy but all could walk independently. Cognitive, visual, language, behavioral, and seizure problems were highly prevalent and correlated significantly with the severity of WM injury and poor postnatal head growth.
CONCLUSION: Infants with HIE and selective WM/cortical injury have a low prevalence of cerebral palsy but have a wide range of other problems, which occur more often with severe WM/cortical lesions.
Authors:
Miriam Martinez-Biarge; Tina Bregant; Courtney J Wusthoff; Andrew T M Chew; Jesus Diez-Sebastian; Mary A Rutherford; Frances M Cowan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-07
Journal Detail:
Title:  The Journal of pediatrics     Volume:  161     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-25     Completed Date:  2013-01-10     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  799-807     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Basal Ganglia / pathology
Brain / pathology*
Brain Injuries / diagnosis
Cephalometry
Cerebral Palsy / diagnosis
Child, Preschool
Gestational Age
Humans
Hypoxia-Ischemia, Brain / diagnosis*,  etiology,  physiopathology*
Infant
Infant, Newborn
Intelligence Tests
Magnetic Resonance Spectroscopy / methods
Thalamus / pathology
Treatment Outcome
Grant Support
ID/Acronym/Agency:
MR/K006355/1//Medical Research Council; //Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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