Neonatal Hypoxic-Ischemic Encephalopathy. clinico-radiological(CT) correlations in acute and chronic state

Lipp, A; Deonna, T; Chrzanowski, R; E, Cêtre; Calame, A; Micheli, Jean-Léopold; Gautier, E

doi:10.1203/00006450-198012000-00083

Cited by 2 publications

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“…Conversely, Fitzhardinge et al (1981) found a fairly good correlation between the occurrence of LD areas and later outcome, but this study yielded a fairly high rate of errors in prediction (23 0 /0). By comparing serial CT scans in a restricted sampie of asphyxiated term babies, we have found (Lipp et al 1980, Lipp et al 1984 that the main reason for such discrepant findings is probably the timing of CT scans: LD areas seen in scans performed in the first week (early CT) showed no apparent relation to neonatal neurological findings and later outcome, whereas scans performed between day 9-23 (intermediate CT) showed very distinct low density zones in babies with neurological problems.…”

Section: Introductlonmentioning

confidence: 73%

Prognostic Value of Neonatal CT Scans in Asphyxiated Term Babies: Low Density Score Compared with Neonatal Neurological Signs

Ae¹,

Deonna²,

Jl³

et al. 1985

Neuropediatrics

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Twenty-five asphyxiated term babies were investigated in order to evaluate the prediction of their neurodevelopmental outcome by means of computerized tomography (CT) as compared to neurological symptoms during the neonatal period. Low density (LD) areas, thought to represent hypoxicischaemic lesions, were assessed quantitatively by means of a LD score based on the extent and degree of LD, the total score ranging from 0-36. Neonatal scans were defined according to the time span elapsed between asphyxia and CT as (1) early CT (day 1-7, n = 15), and (2) intermediate CT (day 9-23: n = 14; day 29: n = 1). The newborns were classified according to the neonatal neurological findings as having mild (n = 8, 32%), moderate (n = 9, 36%), and severe (n = 8, 32%) encephalopathy, following the definition of Sarnat and Sarnat (1976). Among the twenty-two survivors, the follow-up (mean age 19.2 +/- 6.0 mts) revealed fourteen (56%) with normal outcome, two (8%) with transient neurodevelopmental anomalies during the first year, and nine (36%) with permanent abnormalities such as cerebral palsy and/or retardation (mainly global) and/or epilepsy. Early CT scans had no predictive value. Intermediate CT, however, showed distinct variations of LD areas which resulted in an LD score well correlated with the later outcome. In particular, a LD score below 14 characterized every baby who developed normally; a prediction not possible in a reliable way be means of neonatal neurological signs. For all abnormal children, the score correlated with the severity of the later neurodevelopmental disorder, except for one with the latest intermediate CT (day 29).

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Section: Introductlonmentioning

confidence: 73%

Prognostic Value of Neonatal CT Scans in Asphyxiated Term Babies: Low Density Score Compared with Neonatal Neurological Signs

Ae¹,

Deonna²,

Jl³

et al. 1985

Neuropediatrics

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Temporal evolution of hypoxis-ischaemic brain lesions in asphyxiated full-term newborns as assessed by computerized tomography

et al. 1985

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Hypoxic-ischaemic brain lesions may be detected as low density (LD) areas by means of computerized tomography (CT), but the clinical significance of such LD areas has been controversial. Since timing might be a critical factor, we studied the temporal evolution of LD areas in 9 asphyxiated term babies who had had two or more CT, and compared the changes to the neurodevelopmental outcome. Scans were classified according to the elapsed time after asphyxia as early (day 1-7, n = 6), intermediate (week 2-4, n = 7; week 4-7, n = 3) and late CT (3 months or more, n = 7). In early scans, no, or only ill defined, LD areas were seen in the periventricular region. In intermediate CT's, LD-zones were further diminished in those babies who later were normal. Sharply accentuated LD areas, however, appeared in those who later suffered from neurodevelopmental disorders. These LD areas, probably representing hypoxic-ischaemic lesions, were located periventricularly, extending into the subcortical white matter and the cortex, and usually involved both hemispheres symmetrically. They began to disappear at 4 to 7 weeks in some regions, possibly because of glial proliferation. LD persisting more than 4-7 weeks tended to transform into cyst-like lesions, or marked atrophy. We conclude (1) that hypoxic-ischaemic lesions appear as zones of low density on CT scans performed after the first week and (2) that the extent of such lesions can best be assessed between 9 to 23 days after asphyxia.

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Neonatal Hypoxic-Ischemic Encephalopathy. clinico-radiological(CT) correlations in acute and chronic state

Cited by 2 publications

References 0 publications

Prognostic Value of Neonatal CT Scans in Asphyxiated Term Babies: Low Density Score Compared with Neonatal Neurological Signs

Prognostic Value of Neonatal CT Scans in Asphyxiated Term Babies: Low Density Score Compared with Neonatal Neurological Signs

Temporal evolution of hypoxis-ischaemic brain lesions in asphyxiated full-term newborns as assessed by computerized tomography

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