MRI for neurodevelopmental prognostication in the high-risk term infant

Massaro, An N.

doi:10.1053/j.semperi.2015.01.009

Cited by 20 publications

(24 citation statements)

References 105 publications

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“…[26, 27] We used T1/T2-weighted images, trace of diffusion images, and ADC maps given the high specificity and sensitivity of these sequences in predicting neurodevelopmental outcomes. [28] In addition, qualitatively scoring brain injury on MRI during the first two weeks of life and after therapeutic hypothermia has consistent and high predictive accuracy for neurodevelopmental outcome.…”

Section: Discussionmentioning

confidence: 99%

Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury

Lee¹,

Poretti²,

Perin

et al. 2016

Dev Neurosci

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Background: Therapeutic hypothermia provides incomplete neuroprotection for neonatal hypoxic-ischemic encephalopathy (HIE). We examined whether hemodynamic goals that support autoregulation are associated with decreased brain injury and whether these relationships are affected by birth asphyxia or vary by anatomic region. Methods: Neonates cooled for HIE received near-infrared spectroscopy autoregulation monitoring to identify the mean arterial blood pressure with optimized autoregulatory function (MAP_OPT). Blood pressure deviation from MAP_OPT was correlated with brain injury on MRI after adjusting for the effects of arterial carbon dioxide, vasopressors, seizures, and birth asphyxia severity. Results: Blood pressure deviation from MAP_OPT related to neurologic injury in several regions independent of birth asphyxia severity. Greater duration and deviation of blood pressure below MAP_OPT were associated with greater injury in the paracentral gyri and white matter. Blood pressure within MAP_OPT related to lesser injury in the white matter, putamen and globus pallidus, and brain stem. Finally, blood pressures that exceeded MAP_OPT were associated with reduced injury in the paracentral gyri. Conclusions: Blood pressure deviation from optimal autoregulatory vasoreactivity was associated with MRI markers of brain injury that, in many regions, were independent of the initial birth asphyxia. Targeting hemodynamic ranges to optimize autoregulation has potential as an adjunctive therapy to hypothermia for HIE.

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Section: Discussionmentioning

confidence: 99%

Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury

Lee¹,

Poretti²,

Perin

et al. 2016

Dev Neurosci

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“…Moderate or severe neonatal encephalopathy puts the newborn at risk for substantial neurodevelopmental sequelae10). HIE is a short-term neurological dysfunction caused by perinatal asphyxia and is a leading cause of infant mortality and long-term neurologic disability1112). Permanent neurological damage is rare in infants with mild perinatal asphyxia.…”

Section: Discussionmentioning

confidence: 99%

“…MRI abnormalities during the neonatal period have been found to be related to later neurodevelopmental outcomes, particularly in infants presenting with HIE1122). A recent study assessed the ability of neonatal MRI to predict neurodisability at 2 years in patients with neonatal seizures, finding that the risks of death or moderate to severe neurodevelopmental impairment were very low in the absence of major cerebral lesions on MRI in patients with HIE.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia

et al. 2016

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PurposeThis study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia.MethodsAll late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2 years were included in this retrospective study. Abnormal neurological outcomes were defined as cerebral palsy, developmental delay and epilepsy.ResultsOf the 114 infants with perinatal asphyxia, 31 were lost to follow-up. Of the remaining 83 infants, 10 died, 56 had normal outcomes, and 17 had abnormal outcomes: 14 epilepsy (82.4%), 13 cerebral palsy (76.5%), 16 developmental delay (94.1%). Abnormal outcomes were significantly more frequent in infants with later onset seizure, clinical seizure, poor electroencephalography (EEG) background activity, lower Apgar score at 1 and 5 minutes and abnormal brain imaging (P<0.05). Infants with and without epilepsy showed significant differences in EEG background activity, clinical and electrographic seizures on EEG, Apgar score at 5 minutes and brain imaging findings.ConclusionWe should apply with long-term video EEG or amplitude integrated EEG in order to detect and management subtle clinical or electrographic seizures in neonates with perinatal asphyxia. Also, long-term, prospective studies with large number of patients are needed to evaluate more exact prognostic factors in neonates with perinatal asphyxia.

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“…; Miller et al . ; Massaro ). Other lesions may include haemorrhages, focal‐multifocal white matter injury and global brain injury in the most severe cases (Massaro ).…”

Section: Discussionmentioning

confidence: 99%

“…; Massaro ). Other lesions may include haemorrhages, focal‐multifocal white matter injury and global brain injury in the most severe cases (Massaro ). In infants, involvement of the basal ganglia/thalamic region is strongly associated with a risk of motor impairment and cerebral palsy whereas watershed injury is associated with impaired cognitive and language domains (Miller et al .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging of presumptive neonatal encephalopathy in a foal

Wong

Jeffery

Hepworth-Warren

et al. 2016

Equine Veterinary Education

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Summary A 10‐h‐old Thoroughbred foal presented with clinical signs consistent with neonatal encephalopathy including absent suckling behaviour, lack of affinity for the mare and seizures. The foal was provided supportive care and treated with broad‐spectrum antimicrobials and fed via naso‐oesophageal tube. In addition, magnetic resonance imaging (MRI) was performed to investigate for structural changes that might be evident with equine neonatal encephalopathy. Notable findings on MRI included hyperintensity of the basal nuclei and superficial layers of the ventral cerebral hemispheres as well as the ventral thalamic nuclei and rostral aspect of the ventral midbrain. These imaging changes were consistent with the counterpart disease in infants and are the first to document MRI changes in a foal with neonatal encephalopathy. This report serves as an initial description of MRI findings associated with the presumed diagnosis of equine neonatal encephalopathy and also serves to solicit future diagnostic imaging studies that may help elucidate the pathophysiology and prognosis of equine neonatal encephalopathy.

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MRI for neurodevelopmental prognostication in the high-risk term infant

Cited by 20 publications

References 105 publications

Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury

Optimizing Cerebral Autoregulation May Decrease Neonatal Regional Hypoxic-Ischemic Brain Injury

Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia

Magnetic resonance imaging of presumptive neonatal encephalopathy in a foal

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