Isolated acute non-cystic white matter injury in term infants presenting with neonatal encephalopathy.
We discuss possible aetiological factors, MRI evolution of injury and neuro-developmental outcomes of neonatal encephalopathy (NE). Thirty-six consecutive infants diagnosed with NE were included. In this cohort, four infants (11%) were identified with injury predominantly in the deep white matter on MRI who were significantly of younger gestation, lower birthweight with higher Apgars at one and five minutes compared to controls. Placental high grade villitis of unknown aetiology (VUA) was identified in all four of these infants. Our hypothesis states VUA may induce white matter injury by causing a local inflammatory response and/or oxidative stress during the perinatal period. We underline the importance of continued close and systematic evaluation of all cases of NE, including examination of the placenta, in order to come to a better understanding of the clinical presentation, the patterns of brain injury and the underlying pathophysiological processes.
Department of Neonatology, National Maternity Hospital, Holles Street, Dublin 2, Ireland. mjjbarrett@hotmail.com
Michael Joseph
MJ
Barrett
Veronica
V
Donoghue
Eoghan E
EE
Mooney
Marie
M
Slevin
Thara
T
Persaud
Eilish
E
Twomey
Stephanie
S
Ryan
Eoghan
E
Laffan
Anne
A
Twomey
D001724:Birth Weight; D001930:Brain Injuries / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D002658:Developmental Disabilities / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D010922:Placenta Diseases / Q000473:pathology / Q000523:psychology; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies