MR patterns of hypoxic-ischemic brain damage after prenatal, perinatal or postnatal asphyxia.
The relationship between MR patterns of brain damage and type or timing of perinatal hypoxia-ischemia was studied. MR images of 104 children with evidence of bilateral posthypoxic-ischemic brain damage and neonatal records were reviewed. Three different MR patterns were found. Periventricular leukomalacia occurred in 73 children, in 82% after a history of subacute or chronic hypoxia-ischemia, in 71% after preterm birth. Predominant lesions of basal ganglia and thalamus occurred in 21 children, in 95% preceded by acute profound asphyxia, in 85% after term birth. Multicystic encephalopathy occurred in 10 infants, in 70% preceded by mild signs of hypoxia-ischemia, followed by an unexpectedly severe encephalopathy, in 60% after term birth. Statistical analysis showed that the patterns of injury were primarily related to the type of hypoxia-ischemia. We conclude that the type of hypoxia-ischemia, rather than the postconceptional age at occurrence determines the pattern of brain injury.
Sie
L T
LT
Department of Child Neurology, Free University Hospital, Amsterdam, The Netherlands.
van der Knaap
M S
MS
Oosting
J
J
de Vries
L S
LS
Lafeber
H N
HN
Valk
J
J
D001238:Asphyxia Neonatorum / Q000150:complications*; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D005315:Fetal Diseases; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D010500:Perinatology; D012189:Retrospective Studies; D012307:Risk Factors