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Published on: January 20, 2023
Brain injury in the infant: the old, the new, and the uncertain
Lina Kurdahi Badr Zahr1, Isabell Purdy
1School of Nursing, Azusa Pacific University, and David Geffen School of Medicine, University of California at Los Angeles, CA, USA. linakbadr@hotmail.com
Insights
Neonatal brain injury, often from hypoxic-ischemic insults, affects 2-5 per 1,000 births. This review covers causes, diagnosis, and management of infant brain injury, highlighting challenges in treatment.
Area of Science:
- Neonatal neurology
- Pediatric neurosurgery
- Developmental pediatrics
Background:
- Neonatal brain injury frequently follows hypoxic-ischemic insults but also arises from metabolic and reperfusion events.
- Incidence is 2-5 per 1,000 live births in the US, higher in developing nations.
- Survivors face significant neurological and developmental impairments, posing challenges for families and healthcare.
Purpose of the Study:
- To provide a comprehensive review of neonatal brain injury.
- To discuss the pathology, clinical manifestations, and management strategies.
- To highlight current challenges and insights in the field.
Main Methods:
- Literature review of recent studies on neonatal brain injury.
- Synthesis of data on epidemiology, diagnosis, and mechanisms.
- Analysis of current management approaches and their controversies.
Main Results:
- Neonatal brain injury has diverse etiologies beyond hypoxic-ischemia.
- Significant long-term neurodevelopmental deficits occur in a substantial portion of survivors.
- Effective management strategies remain largely unresolved, relying on controversial interventions.
Conclusions:
- Understanding the varied causes and impacts of neonatal brain injury is crucial.
- Timely diagnosis and comprehensive management are essential for improving outcomes.
- Further research is needed to establish evidence-based treatment protocols for infant brain injury.
Abstract:
Although neonatal brain injury occurs most frequently after a perinatal hypoxic-ischemic insult, recently studies have noted that variable causes such as metabolic and reperfusion events can result in, or aggravate, a brain insult. Current data suggest that about 2 to 5 of 1,000 live births in the United States and more so in developing countries experience a brain injury Approximately 20% to 40% of infants who survive the brain injury develop significant neurological and developmental impairments. The resulting impact on the child, family, and society presents a formidable challenge to health care professionals. Although several important insights have been gained in the last several years about the epidemiology, diagnosis, and mechanism of brain injury, management remains mostly a cocktail of controversial trials. This article provides a comprehensive review of the pathology, clinical manifestations, and timely management of infants with brain injury.
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