Perinatal hypoxic-ischaemic brain injury: prediction of outcome

Twenty-six term babies with hypoxic-ischaemic brain injury were studied during the neonatal period to evaluate the prediction of outcome to at least one year of age by means of ultrasonography, CT scanning and Doppler ultrasound assessment of cerebral palsy blood flow velocity (CBFV). Adverse outcome was defined as the occurrence of cerebral palsy, developmental delay or death. At follow-up, 17 infants had an adverse outcome (seven died, 10 had disability); the remainder had no detectable impairment. Abnormalities on cranial ultrasound were not, but generalised decreased tissue density on CT scan was, associated with adverse outcome. Abnormal mean CBFV in the middle cerebral artery had no association with outcome, but abnormal mean CBFV in the anterior cerebral artery and a low resistance index in both arteries were significantly associated with adverse outcome. Such information may be used for appropriate counselling of parents of asphyxiated infants.