Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

Salas, Jacqueline; Tekes, Aylin; Hwang, Misun; Northington, Frances J.; Huisman, Thierry A.G.M.

doi:10.1159/000487913

Cited by 47 publications

(53 citation statements)

References 84 publications

(115 reference statements)

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“…In clinical practice, unlike experimental studies, the hypoxic-ischemic insult is not always clearly defined in infants [24,31]. First, the injury begins many hours before birth and often involves repeated or prolonged exposure to hypoxia-ischemia.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Brain Injury and Clinical Biomarkers in Hypoxic-Ischemic Newborn Piglets

Álvarez¹,

Álvarez²,

Lafuente³

et al. 2019

obm neurobiol

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Background: The newborn affected by severe hypoxic-ischemic brain injury usually end up dying, and those who survive suffer neurodevelopmental handicaps. Biomarkers are required to identify the hypoxic-ischemic insult in order to determine the early rescue treatment method to be followed. The aim of the present study was to correlate relevant biomarkers to the pathophysiological process of hypoxic-ischemic brain injury at 6 h and 72 h in newborn piglets. Methods: Hypoxia-ischemia was induced in the piglets by clamping both the carotid arteries and reducing the inspired oxygen. Animals were assigned randomly into two groups: the

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Section: Discussionmentioning

confidence: 99%

Relationship between Brain Injury and Clinical Biomarkers in Hypoxic-Ischemic Newborn Piglets

Álvarez¹,

Álvarez²,

Lafuente³

et al. 2019

obm neurobiol

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“…Ультразвукове дослідження головного мозку (ней росонографія, НСГ) є потужним засобом діагностики новонароджених із ГІЕ для визначення характеру, тер мінів і ступеня ураження, а також засобом диференці альної діагностики з іншими патологічними станами, які можуть призвести до подібної клінічної картини. Крім того, НСГ має додаткові переваги: можливість повторних безпечних обстежень критично хворих па цієнтів, які занадто нестабільні для транспортування; можливість моніторингу прогресування захворювання; відсутність побічних ефектів та потреби седації пацієн та; відносно низька вартість порівняно з МРТ [13][14][15][16].…”

Section: вступunclassified

“…Дані останніх досліджень сповіщають, що як ран ній предиктор наслідків ГІЕ чутливість НСГознак структурних змін мозкової тканини становить 0,79 (до вірчий інтервал -0,30-0,97), а специфічність -0,55 (0,39-0,70) (для порівняння специфічність МРТDWI протягом першого тижня життя -0,75 (0,26-0,96), а специфічність -0,58 (0,23-0,87) [14]. Нормальні ре зультати додаткових обстежень на ранніх етапах захво рювання не є сильними прогностичними факторами сприятливого прогнозу ні при проведенні НСГ, ні при проведенні МРТ [13].…”

Section: вступunclassified

Destructive hypoxic-ischemic brain injury in full-term infants with normothermia and hypothermia

Mavropulo

Sokolova

Капшученко

2021

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Background. Despite the achievements of neonatology, severe asphyxia at birth and hypoxic-ischemic encephalopathy in full-term infants are still associated with high lethality, long-term neurological morbidity and disability. In the algorithm for the management of children with hypoxic-ischemic encephalopathy, it is important to use methods of additional examinations, including ultrasound examination of the brain (neurosonography), its potential for the early evaluation of the severity of the brain tissue injury using therapeutic hypothermia. Thus, the aim of the research was to determine the effect of therapeutic hypothermia on the severity of neurosonographic signs of destructive hypoxic-ischemic brain injury in full-term newborns. Materials and methods. Data were analyzed for 50 full-term neonates with severe asphyxiation and signs of destructive hypoxic-ischemic brain injury. The first group (hypothermia group 1) included 12 newborn infants who were treated with hypothermia in 2014–2016. The second group (hypothermia group 2) — 14 children with severe asphyxiation who were treated with hypothermia in 2011–2013. The third group (group of normothermia) consisted of 24 full-term babies born in 2009–2010, with no therapeutic hypothermia. Results. The share of the most severe destructive brain injuries (diffuse ischemic lesions) was 33.3 % in the first group, 35.7 % in the second group and 45.8 % in the third group. Significant differences between groups in terms of the frequency of diffuse ischemic brain injures were not found. In general, in the structure of destructive hypoxic-ischemic brain injuries in newborns after hypothermia, diffuse ischemic lesions were detected in 34.6 % of cases (non-significant differences with the group of normothermia, p = 0.385 according to Fisher’s criterion calculations). When studying the indicators of cerebral blood flow, reliable differences were found for the index of resistance of the anterior cerebral artery on the third day of life (0.53 ± 0.05 for normothermia group and 0.65 ± 0.04 for hypothermia group). Conclusions. Despite the reduction in the proportion of the most severe diffuse ischemic brain injuries among the total number of diagnosed destructive hypoxic-ischemic lesions during the introduction of hypothermia, the statistical analysis did not reveal any significant differences between the groups. After all, the development of diffuse ischemic brain injuries, first of all, is due to primary asphyxia lesions that lead to global deaths of neurons, or by these injuries, the phase of the therapeutic window in which ended up at the time of birth. But significant differences in the parameters of cerebral hemodynamics prove the fact that the potential of therapeutic hypothermia for the prevention of secondary reperfusion injury remains in these cases.

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“…HUS was performed by experienced pediatric sonographers, using state-of-the-art ultrasound (US) equipment (Zonare, Medical Systems, Mountain View, CA). A standardized set of images was obtained through the anterior fontanel in coronal and sagittal planes using curved and linear array transducers (8)(9)(10)(11)(12)(13)(14)(15)(16)(17) MHz) ( Figs 1A and 1B). The angle of the transducer was varied when needed to evaluate the periphery of the brain.…”

Section: Acquisition Of Hus Datamentioning

confidence: 99%

“…Recent research suggests that data collected by HUS are of prognostic significance in HII. [14][15][16] In addition to subjective image interpretation, objective, quantitative data collection in HUS can be correlated with follow-up DTI scalars.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Predicts White Matter Integrity after Hypothermia Therapy in Neonatal Hypoxic‐Ischemic Injury

Salas

Reddy

Carson

et al. 2019

Journal of Neuroimaging

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BACKGROUND: Hypoxic-ischemic injury (HII) is a major cause of neonatal death and neurodevelopmental disability. Head ultrasounds (HUS) in neonates with HII often show enhanced gray/white matter differentiation. We assessed the significance of this finding in predicting white matter structural integrity measured by diffusion tensor imaging (DTI) in neonates with HII. METHODS:We performed a quantitative region of interest-based analysis of white and gray matter echogenicity within the cingulate gyrus on pre-and posthypothermia HUS. We also completed a quantitative analysis of fractional anisotropy (FA) and mean (MD), axial (AD), and radial (RD) diffusivity within the bilateral anterior and posterior centrum semiovale (CSO) on posthypothermia brain magnetic resonance imaging. For HUS studies, we calculated a white-to-gray matter echogenicity ratio (WGR) and subsequently correlated it to DTI measurements. RESULTS: Forty-two term neonates with HII who underwent hypothermia therapy were included. Significant correlation was found between prehypothermia WGR and MD, AD, and RD values in the leftanterior CSO (r = .38-.40, P = .02). Prehypothermia WGR also correlated with the following: MD and RD in the right anterior CSO (r = .35-.36, P = .04), MD and AD in the right posterior CSO (r = .32-.45, P = .008-.03), and AD in the left posterior CSO (r = .47, P = .005). No significant correlation was found either between prehypothermia WGR and FA values in the bilateral anterior and posterior CSO or between posthypothermia WGR and all DTI scalars in the bilateral anterior and posterior CSO. CONCLUSIONS: Prehypothermia HUS WGR may predict posthypothermia white matter structural integrity and is potentially an early and easily obtainable biomarker of severity in neonatal HII.

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Head Ultrasound in Neonatal Hypoxic-Ischemic Injury and Its Mimickers for Clinicians: A Review of the Patterns of Injury and the Evolution of Findings Over Time

Cited by 47 publications

References 84 publications

Relationship between Brain Injury and Clinical Biomarkers in Hypoxic-Ischemic Newborn Piglets

Relationship between Brain Injury and Clinical Biomarkers in Hypoxic-Ischemic Newborn Piglets

Destructive hypoxic-ischemic brain injury in full-term infants with normothermia and hypothermia

Ultrasound Predicts White Matter Integrity after Hypothermia Therapy in Neonatal Hypoxic‐Ischemic Injury

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