title: Brain magnetic resonance imaging and outcome after hypoxic ischaemic encephalopathy.
abstract: OBJECTIVE
  To correlate pattern of injury on neonatal brain magnetic resonance imaging (MRI) with outcome in infants ≥36 + 0 weeks gestation with hypoxic ischaemic encephalopathy.
  
  
  METHODS
  Prospective cohort study. Images were blindly reviewed. Children were assessed using a variety of standardised assessments.
  
  
  RESULTS
  MRI brain was performed on 88 infants. Follow up was available in 73(83%) infants. Eight of 25(32%) children with normal imaging had below normal assessment scores. Eight infants (12%) had isolated punctate white matter lesions and five of these had abnormal assessment scores. Death and cerebral palsy were seen only in children with imaging scores ≥3 on basal ganglia/thalami (BGT) score or ≥4 on watershed score. No developmental concerns were raised in 3/7(43%) infants with isolated watershed injury. Ten of 13(77%) infants with isolated BGT injury died or developed cerebral palsy. All 23 children with posterior limb of the internal capsule (PLIC) injury displayed developmental difficulties.
  
  
  CONCLUSIONS
  Almost one-third of infants with a normal MRI brain may be at risk of developmental problems. Punctate foci of white matter injury are common and not always benign. PLIC involvement is usually associated with neurological sequelae including isolated cognitive deficits. Worst outcomes are associated with basal ganglia injury.
authors.affiliation: a Rotunda Maternity Hospital , Dublin , Ireland .
authors.forename: Breda C
authors.initials: BC
authors.lastname: Hayes
authors.affiliation: b The Children's University Hospital , Dublin , Ireland , and.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ryan
authors.affiliation: b The Children's University Hospital , Dublin , Ireland , and.
authors.forename: Cliona
authors.initials: C
authors.lastname: McGarvey
authors.affiliation: a Rotunda Maternity Hospital , Dublin , Ireland .
authors.forename: Siobhan
authors.initials: S
authors.lastname: Mulvany
authors.affiliation: b The Children's University Hospital , Dublin , Ireland , and.
authors.forename: Elaine
authors.initials: E
authors.lastname: Doherty
authors.affiliation: a Rotunda Maternity Hospital , Dublin , Ireland .
authors.forename: Andrea
authors.initials: A
authors.lastname: Grehan
authors.affiliation: b The Children's University Hospital , Dublin , Ireland , and.
authors.forename: Cathy
authors.initials: C
authors.lastname: Madigan
authors.affiliation: a Rotunda Maternity Hospital , Dublin , Ireland .
authors.forename: Tom
authors.initials: T
authors.lastname: Matthews
authors.affiliation: b The Children's University Hospital , Dublin , Ireland , and.|c School of Medicine and Medical Science, University College , Dublin , Ireland.
authors.forename: Mary D
authors.initials: MD
authors.lastname: King
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000151:congenital* / Q000175:diagnosis* / Q000453:epidemiology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging / Q000379:methods*; D011379:Prognosis
keywords: Basal ganglia; PLIC; patterns of injury; watershed