title: Neonatal brain injury as a consequence of insufficient cerebral oxygenation.
abstract: Neonatal brain hypoxic-ischemic injury represents a serious health care and socio-economical problem since it is one of the most common causes of mortality and morbidity of newborns. Neonatal hypoxic-ischemic encephalopathy is often associated with signs of perinatal asphyxia, with an incidence of about 2-4 per 1,000 live births and mortality rate up to 20%. In about one half of survivors, cerebral hypoxic-ischemic insult may result in more or less pronounced neuro-psychological sequelae of immediate or delayed nature, such as seizures, cerebral palsy or behavioural and learning disabilities, including attention-deficit hyperactivity disorder. Hypoxic-ischemic injury develops as a consequence of transient or permanent restriction of blood supply to the brain. Severity of hypoxic-ischemic encephalopathy varies depending on the intensity and duration of hypoxia-ischemia, on the type and size of the brain region affected, and on the maturity of the foetal/neonatal brain. Though a primary cause of hypoxic-ischemic injury is lack of oxygen in the neonatal brain, underlying mechanisms of subsequent events that are critical for developing hypoxic-ischemic encephalopathy are less understood. Their understanding is however necessary for elaborating effective management for newborns that underwent cerebral hypoxic-ischemic insult and thus are at risk of a negative outcome. The present paper summarizes current knowledge on cerebral hypoxic-ischemic injury of the neonate, fundamental processes involved in etiopathogenesis, with a special focus on cellular and molecular mechanisms and particular attention on certain controversial aspects of oxidative stress involvement.
authors.affiliation: Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovakia.
authors.forename: Katerina
authors.initials: K
authors.lastname: Placha
authors.affiliation: Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovakia.
authors.forename: Dominika
authors.initials: D
authors.lastname: Luptakova
authors.affiliation: In-vivo NMR Laboratory, Faculty of Chemical and Food Technology, Slovak Technical University, Bratislava, Slovakia.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Baciak
authors.affiliation: Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovakia.
authors.forename: Eduard
authors.initials: E
authors.lastname: Ujhazy
authors.affiliation: Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovakia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Juranek
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D001921:Brain / Q000503:physiopathology; D005260:Female; D006801:Humans; D000860:Hypoxia; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000209:etiology; D011247:Pregnancy; D011596:Psychomotor Disorders / Q000209:etiology