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The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
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Can postmortem computed tomography detect antemortem hypoxic-ischemic encephalopathy?

Go Shirota1, Masanori Ishida1,2, Yukako Shintani3

  • 1Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Forensic Science, Medicine, and Pathology
|June 26, 2016
PubMed
Summary
This summary is machine-generated.

Brain postmortem CT scans can detect hypoxic-ischemic encephalopathy (HIE) before death. Findings like effaced sulci and basal ganglia contrast loss indicate HIE, aiding in postmortem diagnosis.

Keywords:
Brain swellingForensic radiologyGlobal hypoxiaHypoxic–ischemic encephalopathyPostmortem computed tomographyRespirator brain

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Area of Science:

  • Forensic pathology
  • Neuroradiology
  • Neuropathology

Background:

  • Hypoxic-ischemic encephalopathy (HIE) is a critical condition affecting the brain.
  • Accurate ante-mortem diagnosis of HIE is crucial for patient management.
  • Postmortem computed tomography (PMCT) is increasingly used in forensic investigations.

Purpose of the Study:

  • To assess the utility of brain PMCT in identifying global hypoxia or hypoperfusion preceding death.
  • To correlate PMCT findings with pathological evidence of HIE.

Main Methods:

  • Brain PMCT and autopsy were performed on non-traumatic cadavers.
  • Cases were divided into HIE (n=6) and control (n=37, age-matched n=8) groups.
  • PMCT parameters analyzed: central sulcus width, basal ganglia attenuation, gray-white matter attenuation differences.

Main Results:

  • Significant differences in central sulcus width and basal ganglia attenuation were observed between HIE and control groups (P<0.001).
  • Cerebral gray-white matter attenuation differed significantly between HIE and overall control groups (P=0.009).
  • Age-matched controls also showed significant differences in central sulcus width (P=0.026) and basal ganglia attenuation (P<0.001).

Conclusions:

  • Brain PMCT findings, specifically effacement of cerebral sulci and loss of contrast at the basal ganglia, suggest prior HIE.
  • PMCT offers a valuable non-invasive tool for detecting HIE ante-mortem.