Inability to verify parasagittal cerebral injury as a neuropathologic entity in the asphyxiated term neonate

Localization of brain injury to parasagittal arterial border zones in the asphyxiated term neonate has been recently described as a frequent, clinically significant finding. However, pathologic examination of the brains of 79 term infants did not reveal a parasagittal distribution of damage. Coronal CT scans of 13 asphyxiated neonates with clinical findings of proximal hypotonia, and repeat scans 6-12 months later in seven patients, have not demonstrated watershed areas of decreased density. A larger series of prospectively identified, surviving neonates is needed to determine whether clinically relevant parasagittal injury may be present in this population.