title: Injury to the Cerebellum in Term Asphyxiated Newborns Treated with Hypothermia.
abstract: OBJECTIVE
  Until now, most studies of brain injury related to term neonatal encephalopathy have focused on the cerebrum and ignored the cerebellum. We sought to evaluate whether cerebellar injury occurs in term asphyxiated neonates.
  
  
  METHODS
  Asphyxiated neonates treated with hypothermia were enrolled prospectively. Severity of brain injury in the cerebrum was scored on each MR imaging obtained during the first month of life; cerebellar injury was recorded when mentioned in the imaging or autopsy report. In addition, for some of the neonates, the ADC and fractional anisotropy were measured in 4 regions of interest in the cerebellum.
  
  
  RESULTS
  One hundred seventy-two asphyxiated neonates met the criteria for hypothermia. Cerebellar injury was visible only on conventional imaging of 4% of the neonates for whom brain imaging was available, but it was reported in the autopsy report of 72% of the neonates who died. In addition, 41 of the asphyxiated neonates had a total of 84 ADC and fractional anisotropy maps. Neonates with brain injury described only in the cerebrum demonstrated ADC and fractional anisotropy changes similar to those of the neonates with brain injury in the cerebrum and cerebellum--increased ADC around day 10 of life and decreased fractional anisotropy on day 2-3 of life, around day 10 of life, and around 1 month of age.
  
  
  CONCLUSIONS
  The cerebellum may be injured in term neonates after birth asphyxia. These cerebellar injuries are only rarely visible on conventional imaging, but advanced neuroimaging techniques may help to identify them.
authors.affiliation: From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.).
authors.forename: S
authors.identifier: http://orcid.org/0000-0002-5547-3302
authors.initials: S
authors.lastname: Kwan
authors.affiliation: From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.).
authors.forename: E
authors.initials: E
authors.lastname: Boudes
authors.affiliation: MR Clinical Science (G.G.), Philips Healthcare, Montreal, Quebec, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Gilbert
authors.affiliation: Division of Pediatric Radiology (C.S.-M.).
authors.forename: C
authors.initials: C
authors.lastname: Saint-Martin
authors.affiliation: Department of Pediatric Pathology (S.A.).
authors.forename: S
authors.initials: S
authors.lastname: Albrecht
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics (M.S.), Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Shevell
authors.affiliation: From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.) pia.wintermark@bluemail.ch.
authors.forename: P
authors.identifier: http://orcid.org/0000-0002-7611-6670
authors.initials: P
authors.lastname: Wintermark
mesh_terms: D016880:Anisotropy; D001238:Asphyxia Neonatorum / Q000473:pathology* / Q000628:therapy; D002531:Cerebellum / Q000293:injuries* / Q000473:pathology; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male