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The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
Published on: November 19, 2008
Restricted diffusion in the corpus callosum in hypoxic-ischemic encephalopathy
Toshiki Takenouchi1, Linda A Heier, Murray Engel
1Division of Pediatric Neurology, Department of Pediatrics, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10021, USA. toshiki.take@gmail.com
Pediatric Neurology
|August 10, 2010
Summary
Restricted diffusion in the splenium of the corpus callosum is a significant early indicator of adverse outcomes in term infants with hypoxic-ischemic encephalopathy. This finding on MRI is linked to increased death or severe developmental delay.
Area of Science:
- Neurology
- Neonatal Medicine
- Radiology
Background:
- Restricted diffusion in the splenium of the corpus callosum is observed in various conditions.
- It is not typically a prominent MRI finding in neonatal hypoxic-ischemic encephalopathy.
- Selective head cooling is a treatment for term neonates with hypoxic-ischemic encephalopathy.
Purpose of the Study:
- To investigate the incidence and significance of restricted diffusion in the splenium of the corpus callosum in term neonates with hypoxic-ischemic encephalopathy.
- To determine if this finding is an early neuroradiologic marker of adverse neurologic outcomes.
Main Methods:
- Review of perinatal characteristics in 42 term neonates with hypoxic-ischemic encephalopathy treated with selective head cooling.
- Review of neonatal MRI scans of 34 infants.
- Comparison of outcomes between infants with and without splenium of the corpus callosum changes.
Main Results:
- Ten of 34 (29%) infants showed restricted diffusion in the splenium of the corpus callosum.
- This group had a significantly higher incidence of death or severe developmental delay (P = 0.002).
- The positive predictive value of splenium changes for poor outcomes or death was 90%.
Conclusions:
- Restricted diffusion in the splenium of the corpus callosum is associated with extensive brain injury in term infants with hypoxic-ischemic encephalopathy.
- It serves as an early neuroradiologic marker of adverse neurologic outcomes.
- Associated factors include lower birth weight, larger base deficits, and more severe encephalopathy.
