Related Experiment Video
Updated: Jun 27, 2026
08:47
The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
Published on: November 19, 2008
35.9K
Pure Insular Cortex Infarct in Sepsis-Induced Hypoxic Ischemic Encephalopathy
Atif Ahmed1, Eric J Basile2, Myra Ahmad3
1Physical Medicine and Rehabilitation, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, New York, USA.
Cureus
|February 1, 2022
Summary
Neonatal sepsis can cause hypoxic ischemic encephalopathy (HIE), a brain injury. This case highlights an unusual MRI finding of isolated insular cortex hypersensitivity in a neonate with HIE due to sepsis.
Area of Science:
- Neurology
- Neonatal Medicine
- Radiology
Background:
- Sepsis affects 1.7 million adults annually in the US, with a 16% mortality rate.
- Neonatal sepsis is a major cause of infant illness and death, leading to complications like hypoxic ischemic encephalopathy (HIE).
- HIE affects 1-5 per 1000 live births globally, particularly premature infants with immature regulatory mechanisms.
Observation:
- Common MRI findings in HIE include white matter injury in premature neonates and basal ganglia-thalamus or watershed ischemia in term neonates.
- This report details a 38-week-old male neonate diagnosed with HIE secondary to sepsis.
- The neonate presented with isolated insular cortex hypersensitivity on FLAIR and T1-weighted MRI sequences.
Findings:
- Isolated insular cortex hypersensitivity is typically associated with middle cerebral artery (MCA) territory strokes but rarely as an isolated finding.
- The observed hypersensitivity persisted for weeks.
- No typical patterns of hypoxia-induced cerebrovascular insult were evident on MRI in this case.
Implications:
- This case expands the understanding of potential MRI presentations of HIE in neonates.
- It suggests that isolated insular cortex hypersensitivity may be an underrecognized sign of HIE in neonatal sepsis.
- Further research is needed to elucidate the pathophysiology and clinical significance of this specific MRI finding.
Keywords:
brain hypoxiabrain infarcthypoxic-ischemic encephalopathymultiple organ failureneonatal sepsisneurological signpediatric neuro radiologyMore Related Videos
Related Concept Videos
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:29Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...