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Published on: October 28, 2022
The Vulnerable Newborn Brain: Imaging Patterns of Acquired Perinatal Injury
1Department of Pediatrics, UCSF Benioff Children's Hospitals, University of California, San Francisco, San Francisco, Calif., USA.
Insights
Advanced imaging aids in understanding newborn brain injuries. This review details distinct patterns of acquired perinatal brain injury, crucial for diagnosis and future therapies.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Neuroimaging
Background:
- Recent advancements in neuroimaging have significantly improved the visualization of the newborn brain.
- These techniques are vital for identifying injury patterns, understanding underlying mechanisms, and guiding clinical management.
Purpose of the Study:
- To review and discuss the characteristic imaging findings of acquired brain injuries in the perinatal period.
- To synthesize current literature and research on distinct imaging patterns associated with neonatal brain insults.
Main Methods:
- Comprehensive literature review.
- Assessment of published data on acquired brain insults in neonates.
- Author's research integration.
Main Results:
- Term infants exhibit unique injury patterns from hypoxia-ischemia, hypoglycemia, and hyperbilirubinemia; stroke is common.
- Preterm infants frequently develop white matter injury influenced by postnatal factors; cerebellar hemorrhages are prevalent.
- Periventricular hemorrhagic infarction, a severe complication of intraventricular hemorrhage, leads to significant disabilities.
Conclusions:
- Acquired perinatal brain injuries can result in lifelong, severe consequences for affected infants.
- Continued research into novel therapeutic strategies is essential to mitigate these devastating outcomes.
Background:
Over the past two decades, imaging techniques have allowed for better visualization of the newborn brain. This has enabled us to detect patterns, understand mechanisms and guide diagnosis and treatment.
Objectives:
The purpose of this review is to discuss imaging characteristics of acquired perinatal brain injury.
Methods:
Through literature review and the author's research, this review assesses published data on the distinct imaging patterns that occur in the neonatal period due to acquired brain insults.
Results:
In the term brain, susceptibility to hypoxia-ischemia, hypoglycemia and hyperbilirubinemia results in unique patterns of injury. Stroke commonly occurs in the newborn period. Infections, especially viral, have distinct patterns of white matter injury. In the preterm brain, white matter injury occurs commonly and is affected by postnatal growth, stress and infection. The cerebellum is uniquely vulnerable during this period, with resultant hemorrhages in almost half of preterm infants. Cerebellar growth is affected by intraventricular hemorrhage, drugs and placental pathology. Periventricular hemorrhagic infarction is the most serious consequence of the spectrum of intraventricular hemorrhage and results in profound disabilities.
Conclusions:
Taken together, the acquired perinatal brain injuries can have lifelong devastating consequences, so the search for therapies must continue.
