Neuron-specific enolase levels and neuroimaging in asphyxiated term newborns

The study was designed to investigate the cerebrospinal fluid and serum levels of neuron-specific enolase, along with cranial ultrasonography, magnetic resonance imaging (MRI), and electroencephalography (EEG), for predicting the clinical state and neurologic outcome of 26 asphyxiated term newborns. The babies were graded according to the Sarnat and Sarnat classification. Cerebrospinal fluid neuron-specific enolase levels of the 18 babies in the whole hypoxic-ischemic encephalopathy group were higher than the 8 babies in the "no encephalopathy" group. Cerebrospinal fluid neuron-specific enolase levels of 13 cases in the hypoxic-ischemic encephalopathy grade 2 and 3 groups (high-risk group) were higher than both the no encephalopathy and hypoxic-ischemic encephalopathy grade 1 groups when pooled. Cerebrospinal fluid neuron-specific enolase levels of the 7 newborns in the hypoxic-ischemic encephalopathy grade 3 group were also significantly higher than the 5 in the hypoxic-ischemic encephalopathy grade 1 group. The findings of cranial MRI, EEG, and cerebrospinal fluid neuron-specific enolase levels were correlated with each other and the clinical grade of the patients and also were predictive of the neurologic outcome at 1 year of age. Cerebrospinal fluid neuron-specific enolase levels, cranial MRI, and EEG are predictive of outcome of hypoxic-ischemic brain damage in asphyxiated newborns, and this predictivity would increase with the combination of these diagnostic parameters.