The aim of the present paper is to review present knowledge about the pathophysiology of perinatal hypoxic-ischemic encephalopathy, especially with respect to novel treatment strategies and biomarkers that might enhance early detection of this disorder [ncbi.nlm.nih.gov]

• Falling

  Small changes in umbilical pH occur within 60 s of delivery, 4 and over 60 min cord arterial or venous pH can fall by more than 0.2 pH units. 5 Similar changes occur in blood sampled from placental surface vessels except that they are larger and less [doi.org]

  As BP falls, CBF falls below critical levels, and the brain injury secondary to diminished blood supply and a lack of sufficient oxygen occurs. This leads to intracellular energy failure. [emedicine.medscape.com]

  The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants. BJOG. 2000 Apr. 107(4):461-6. [Medline]. Srinivasakumar P, Zempel J, Wallendorf M, Lawrence R, Inder T, Mathur A. [medscape.com]

  Smith J, Wells l, Dodd K.The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants. BJOG 2000; 107(4): 461–6. pmid:10759262 View Article PubMed/NCBI Google Scholar 2. García-Alix A, Martinez Biarge M. [journals.plos.org]

  Blood-based biomarkers provide only intermittent ‘snapshots’ of a dynamic rise and fall of each circulating factor after the insult. [ncbi.nlm.nih.gov]

• Feeding Difficulties

  Persistent feeding difficulties, which generally are due to abnormal tone of the muscles of sucking and swallowing, also suggest significant CNS damage. [emedicine.medscape.com]

All neonates with stroke had a negative thrombophilia workup. Neonates with stroke had a significantly higher incidence of seizures and increased initial platelet counts on univariate analysis. [ncbi.nlm.nih.gov]

Cerebral Palsy Workup: Approach Considerations, Potentially Helpful Laboratory Tests, Cranial Imaging Studies. (2018, October 02). Retrieved from https://emedicine.medscape.com/article/1179555-workup . [hiehelpcenter.org]

These guidelines did not address evidence needed for diagnosis of seizures, but were confined to suggestions as to which ASDs were to be considered as 1st-, 2nd- and 3rd-line treatments for seizures, and provided a suggested workup for the potential causes [karger.com]

Electroencephalography (EEG) - Standard and amplitude-integrated EEG Hearing test - An increased incidence of deafness has been found among infants with hypoxic-ischemic encephalopathy who require assisted ventilation Retinal and ophthalmic examination See Workup [emedicine.medscape.com]

The SBU assessment stated: "[t]here is limited evidence that either visually rated EEG or qEEG helps the diagnostic workup differentiate AD (Alzheimer’s Disease) patients from controls or AD from other dementia disorders." [aetna.com]

• Burst Suppression

  Abstract In the prediction of neurological sequelae after hypoxic-ischemic encephalopathy (HIE) in the newborn, the electroencephalogram (EEG) burst suppression pattern (BS) and subcortical leukomalacia can mean grave neurodevelopmental problems will [ncbi.nlm.nih.gov]

  “Burst suppression or generalized epileptiform discharges on EEG predicted poor outcomes but with insufficient prognostic accuracy” NB. [litfl.com]

  Distinct neurophysiological phenomena such as seizures and burst suppression were detected and studied in association to underlying HIE. [repository.cam.ac.uk]

• Periodic Lateralized Epileptiform Discharges

  Gloor et al 29 reviewed postmortem examinations of patients with periodic lateralized epileptiform discharges and saw gray matter lesions only, and metabolic or electrophysiologic etiologies were also implicated in GPDs. 30, 31 These findings suggest [ajnr.org]

  A number of patterns suggest a poor prognosis. 39 These include: generalized electrical suppression or burst suppression; unresponsive α-, θ- or δ-rhythms; periodic patterns (periodic lateralized, bilateral or synchronous epileptiform discharges); the [academic.oup.com]

Further research is needed to better understand if the long-term impact of the experimental treatments and whether the combinations of experimental treatments can improve outcomes in infants with HIE. [ncbi.nlm.nih.gov]

HIE patients were further divided into two groups: poor prognosis and better prognosis. [ncbi.nlm.nih.gov]

EEG monitoring and MRI are important tools in determining the etiology of encephalopathy and prognosis of the infant. [ncbi.nlm.nih.gov]

Etiology and prognosis of alpha coma. Neurology 1988;38:773-7. [ PUBMED ] 5. Kaplan PW, Genoud D, Ho TW, Jallon P. Etiology, neurologic correlations, and prognosis in alpha coma. Clin Neurophysiol 1999;110:205-13. [ PUBMED ] 6. [neurologyindia.com]

If a comprehensive etiologic evaluation is not possible, the term hypoxic–ischemic encephalopathy should best be replaced by neonatal encephalopathy because neither hypoxia nor ischemia can be assumed to have been the unique initiating causal mechanism [pediatrics.aappublications.org]

KEYWORDS: all epilepsy / seizures; childhood stroke; cohort studies; epilepsy; risk factors in epidemiology [ncbi.nlm.nih.gov]

Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. [cambridge.org]

In comparison, epidemiologic studies have suggested that 70% of causation is related to chronic antenatal factors. [pediatrics.aappublications.org]

Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early Hum Dev., 86 (2010), pp. 329-338. [ojs.actapediatrica.org.mx]

Understanding pathophysiology of the brain damage is essential for the early detection of patients with high risk for HIE and development of strategies for their treatments. [ncbi.nlm.nih.gov]

Application of this knowledge will allow us to identify strategies for early intervention and prevent the course of damage caused by hypoxic-ischemic injury. [ncbi.nlm.nih.gov]

This pace and duration prevents reperfusion injury, which can occur when normal oxygen and flood flow restore too rapidly to brain cells. Hypothermia therapy stabilizes brain cells and prevents, or at least limits, inflammation. [news-medical.net]