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[Two cases of two-year-old girls with hypoxic ischemic encephalopathy induced by convulsive status]
Insights
Hypoxic ischemic encephalopathy (HIE) in two young girls presented with paradoxical brain imaging findings. Despite generalized atrophy, specific brain regions showed preserved perfusion, challenging typical HIE injury patterns.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroradiology
Background:
- Hypoxic ischemic encephalopathy (HIE) is a major cause of neonatal brain injury.
- Understanding HIE's long-term neuroimaging manifestations is crucial for prognosis.
- Typical HIE imaging shows injury in specific brain regions.
Observation:
- Two cases of HIE in two-year-old girls with coma and seizures were studied.
- Subacute CT revealed decreased whole brain density, sparing primary sensorimotor and occipital cortices.
- Chronic MRI showed generalized atrophy without abnormal density.
Findings:
- 99mTc-ECD SPECT revealed low cerebral perfusion in most brain areas.
- Paradoxically, primary sensorimotor and occipital cortices showed preserved perfusion.
- This distribution contrasts with commonly injured areas in HIE.
Implications:
- The findings suggest a unique pattern of brain injury and recovery in HIE.
- This challenges the understanding of HIE's long-term neurobiological impact.
- Further research is needed to explore the mechanisms behind this paradoxical perfusion pattern.
Abstract:
We reported two cases of two-year-old girls with hypoxic ischemic encephalopathy. Their symptom was coma induced by seizures with respective factors. CT image on subacute stage showed the decreased density of the whole brain except for the primary sensorimotor cortex and the occipital lobe. MRI and CT images on chronic stage revealed generalized atrophy with no abnormal density areas. 99mTc-ECD SPECT on chronic stage showed low perfusion in the whole brain except for the primary sensorimotor cortex and the occipital lobe, in which areas brain tissue is considered to be injured easily in hypoxic ischemic encephalopathy. The paradoxical distribution of abnormal cerebral perfusion areas in our cases was reported in this paper.