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Neonatal Hypoxic and Ischemic Brain Injury

HIE


Presentation

  • In the present study, we sought to investigate the efficacy of human neural stem cells derived from human embryonic stem cells in a rat model of neonatal HI and the mechanisms enhancing brain repair.[ncbi.nlm.nih.gov]
  • OBJECTIVES: Thus, in the present study, we studied the effects of systemically administered Epo on antiapoptotic (bcl-2, bcl-XL), proapoptotic (bax and DP5) gene expression following hypoxic-ischemic brain injury in neonatal rats.[ncbi.nlm.nih.gov]
  • In this review we briefly highlight the present and potential forthcoming therapeutic treatments aimed at attenuation of the detrimental effects of neonatal hypoxia-ischemia.[ingentaconnect.com]
  • Abstract We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective.[ncbi.nlm.nih.gov]
  • The present results should offer important insights into the prognosis for hypoxic-ischemic encephalopathy. 2014 The Authors. Journal of Obstetrics and Gynaecology Research 2014 Japan Society of Obstetrics and Gynecology.[ncbi.nlm.nih.gov]
Poor Feeding
  • HIE and PVL usually start to occur during the birthing process, with problems such as seizures and poor feeding starting to occur shortly after delivery.[abclawcenters.com]
  • Transient behavioral abnormalities, such as poor feeding, irritability, or excessive crying or sleepiness, may be observed. By 3-4 days of life, the CNS examination findings become normal.[slideshare.net]
Crying
  • Have a weak cry. Show signs of organ dysfunction, especially of the heart, lungs, kidneys, liver and blood.[ucsfbenioffchildrens.org]
  • Transient behavioral abnormalities, such as poor feeding, irritability, or excessive crying or sleepiness, may be observed. By 3-4 days of life, the CNS examination findings become normal.[slideshare.net]
Pain
  • Most of the time, babies with mild symptoms can have a life uninhibited by HIE, whereas babies with severe symptoms may have a shortened lifespan with a number of painful problems.[birthinjuryguide.org]
Feeding Difficulties
  • Persistent feeding difficulties, which generally are due to abnormal tone of the muscles of sucking and swallowing, also suggest significant CNS damage.[slideshare.net]
Weight Gain
  • Serum electrolytes: In severe HIE cases, daily assessment of serum electrolytes are of value until the infant's status improved *low serum sodium, potassium, and chloride *reduced urine flow and excessive weight gain may indicate acute tubular damage[slideshare.net]
Regurgitation
  • Severely depressed respiratory and cardiac functions and signs of brainstem compression Reduced myocardial contractility, severe hypotension, cardiac dilatation, and tricuspid regurgitation are noted frequently in severe HIE.[slideshare.net]
Fracture
  • Examples include brachial plexus injury; fracture of the clavicle; forceps-induced damage to the facial nerve or soft tissues; and cuts or bruises from scissors, clips, or scalp monitors. 4.[slideshare.net]
Cognitive Deficit
  • Abstract Perinatal asphyxia is an important cause of neonatal mortality and subsequent serious sequelae such as motor and cognitive deficits and seizures.[ncbi.nlm.nih.gov]
  • BACKGROUND: Perinatal asphyxia is an important cause of neonatal mortality and subsequent serious sequelae such as motor and cognitive deficits and seizures.[ncbi.nlm.nih.gov]
  • It can cause mortality or detrimental neurological disorders such as cerebral palsy, motor impairment and cognitive deficits in neonates.[ncbi.nlm.nih.gov]
Neonatal Seizures
  • RESULTS: After controlling for severity of injury on MRI, the children with neonatal seizures had worse motor and cognitive outcomes compared with those without seizures.[ncbi.nlm.nih.gov]
  • seizures and neonatal hypoglycemia .[abclawcenters.com]
Irritability
  • Other problems with newborn P90 Convulsions of newborn P91 Other disturbances of cerebral status of newborn P91.0 Neonatal cerebral ischemia P91.1 Acquired periventricular cysts of newborn P91.2 Neonatal cerebral leukomalacia P91.3 Neonatal cerebral irritability[icd10data.com]
  • Transient behavioral abnormalities, such as poor feeding, irritability, or excessive crying or sleepiness, may be observed. By 3-4 days of life, the CNS examination findings become normal.[slideshare.net]

Workup

Hypercapnia
  • Prevent hypoxia, hypercapnia, and hypocapnia; the latter is due to inadequate hyperventilation, which may lead to severe hypoperfusion of the brain.[slideshare.net]
Hypocapnia
  • Prevent hypoxia, hypercapnia, and hypocapnia; the latter is due to inadequate hyperventilation, which may lead to severe hypoperfusion of the brain.[slideshare.net]

Treatment

  • This makes it impossible for physicians to develop a definitive treatment for neonatal cases of HIE. The basic goal of HIE treatment is to support the baby’s affected organs.[birthinjuryguide.org]
  • The challenge now is to select from a daunting range of potential treatments. The patient's best interest must be central to ethical decision making at all times.[ncbi.nlm.nih.gov]
  • The only available effective treatment, hypothermia, neither provides complete brain protection nor stimulates the repair necessary for neurodevelopmental outcome.[ingentaconnect.com]
  • The treatment is called hypothermia (brain cooling) treatment and research shows that it halts almost every injurious process that starts to occur when the brain experiences an oxygen-depriving insult.[abclawcenters.com]
  • Treatment-induced changes in gene expression were investigated by microarray and quantitative polymerase chain reaction. RESULTS: Bioluminescence imaging permitted real time longitudinal tracking of grafted human neural stem cells.[ncbi.nlm.nih.gov]

Prognosis

  • For preterm infants, compared with term infants, the overall prognosis is worse.[radiopaedia.org]
  • The present results should offer important insights into the prognosis for hypoxic-ischemic encephalopathy. 2014 The Authors. Journal of Obstetrics and Gynaecology Research 2014 Japan Society of Obstetrics and Gynecology.[ncbi.nlm.nih.gov]
  • Abnormal clinical neurological findings persisting beyond the first 7-10 days of life usually indicate poor prognosis. Among these, abnormalities of muscle tone and posture (hypotonia, rigidity, weakness) should be carefully noted.[slideshare.net]
  • Once deprived of oxygen they will begin to die off within five minutes. [29] Prognosis [ edit ] Mild and moderate cerebral hypoxia generally has no impact beyond the episode of hypoxia; on the other hand, the outcome of severe cerebral hypoxia will depend[en.wikipedia.org]

Etiology

  • TIAs share the same underlying etiology as strokes; a disruption of cerebral blood flow.[en.wikipedia.org]

Pathophysiology

  • CONCLUSIONS: SHED transplantation into the HI-injured brain resulted in remarkable neurological and pathophysiological recovery.[ncbi.nlm.nih.gov]
  • Abstract We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective.[ncbi.nlm.nih.gov]
  • Berger R, Garnier Y: Pathophysiology of perinatal brain damage. Brain Res Brain Res Rev 1999 Aug; 30(2): de Haan HH, Hasaart TH: Neuronal death after perinatal asphyxia.[slideshare.net]
  • "Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms." NeuroRehabilitation 26 (1): 5-13. Calvert, J. W. and J. H. Zhang (2005). "Pathophysiology of an hypoxic-ischemic insult during the perinatal period."[internationalbrain.org]
  • "Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms". NeuroRehabilitation. 26 (1): 5–13. doi : 10.3233/NRE-2010-0531. PMID 20130351. a b Butterworth, Roger F. (1999). " Hypoxic Encephalopathy ".[en.wikipedia.org]

Prevention

  • Application of this knowledge will allow us to identify strategies for early intervention and prevent the course of damage caused by hypoxic-ischemic injury. Copyright 2001 Harcourt Publishers Ltd.[ncbi.nlm.nih.gov]
  • RESULTS: Epo significantly prevented hypoxia-ischemia-induced bax and DP5 mRNA upregulation in brain tissue. Epo did not show any effect on bcl-XL transcription altered by injury.[ncbi.nlm.nih.gov]
  • Sonia Bonifacio: Preventing Brain Damage in Newborns Intensive Care Nursery Glossary Intensive Care Nursery Parents' Guide UCSF Research & Clinical Trials Newborn Brain Research Institute Search for a Clinical Trial Reviewed by health care specialists[ucsfbenioffchildrens.org]
  • Prevent hypoxia, hypercapnia, and hypocapnia; the latter is due to inadequate hyperventilation, which may lead to severe hypoperfusion of the brain.[slideshare.net]

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