title: Correlation of EEG, CT, and MRI Brain with Neurological Outcome at 12 Months in Term Newborns with Hypoxic Ischemic Encephalopathy.
abstract: OBJECTIVE
  To correlate electroencephalogram (EEG), computed tomography (CT), and magnetic resonance imaging (MRI) brain with neurological outcome at 12 months in term neonates with hypoxic ischemic encephalopathy.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Neonatal intensive care unit (NICU) in a tertiary care teaching hospital.
  
  
  METHODS
  The study was conducted between June 2010 and November 2011. Consecutive term neonates with perinatal asphyxia and hypoxic ischemic encephalopathy were the subjects. All babies were managed as per standard protocol. EEG was done as soon as the baby was stable and CT brain within 7 days. MRI was done at 3 months. Neurodevelpmental assessment was done at 12 months.
  
  
  RESULTS
  Of the 31 babies, four died and one was lost to follow-up. Neurodevelopmental at 12 months of age was normal in 15 babies. EEG was normal in six babies and all of them had a normal neurodevelopment. Thirteen of the 14 babies with burst suppression pattern were abnormal (P<0.001). CT brain was normal in 14 and all of them had normal neurodevelopment (P<0.001), while 11 of the 12 with cerebral edema had abnormal outcome (P<0.001). Of the 16 babies with normal MRI, 14 were normal, while all six babies with abnormal signals in the cortex and thalamus had abnormal outcome (P=0.002).
  
  
  CONCLUSIONS
  A normal EEG and CT brain in a term newborn with hypoxic ischemic encephalopathy (HIE) is associated with good neurological outcome. Burst suppression pattern in EEG, bleeds, or hypodensities in the CT and involvement of basal ganglia/thalamus in the MRI are predictors of abnormal outcome.
authors.affiliation: Department of Pediatrics, PSG Institute of Medical Sciences, Peelamedu, Coimbatore, Tamil Nadu, India.
authors.forename: Annu
authors.initials: A
authors.lastname: Jose
authors.forename: John
authors.initials: J
authors.lastname: Matthai
authors.forename: Sarah
authors.initials: S
authors.lastname: Paul
keywords: Electroencephalogram; hypoxic ischemic encephalopathy; magnetic resonance imaging; magnetic resonance imaging brain; neurodevelopment