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The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
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¿Encefalopatía hipóxica isquémica, accidente cerebrovascular perinatal o ambas cosas? Un informe de caso
Adilah W Ab Rahim1,2, Assyifaa Bt Nik Mazian2,3, Halimah Binti Abdul Halim1,2
1Paediatric Unit, Universiti Sains Islam Malaysia, Nilai, Malaysia.
Journal of neonatal-perinatal medicine
|September 3, 2025
Resumen
El accidente cerebrovascular perinatal puede imitar la encefalopatía hipóxica isquémica (HIE) al nacer, que a menudo se presenta con convulsiones. Este caso destaca la importancia de considerar el accidente cerebrovascular y el uso de la resonancia magnética para un diagnóstico preciso y el inicio adecuado de la hipotermia terapéutica (TH).
Área de la Ciencia:
- Neurología neonatal
- Neurología pediátrica
- Cuidados neurocríticos
Sus antecedentes:
- El accidente cerebrovascular perinatal implica infarto cerebral o hemorragia en recién nacidos de hasta 28 días de edad.
- A menudo presenta convulsiones dentro de las 72 horas posteriores al nacimiento.
- La encefalopatía hipóxica isquémica (HIE) se presenta típicamente con encefalopatía al nacer.
Objetivo del estudio:
- Para presentar un caso de accidente cerebrovascular perinatal inicialmente diagnosticado erróneamente como HIE.
- Discutir los desafíos de diagnóstico y las estrategias de gestión para diferenciar el accidente cerebrovascular perinatal y la EHI.
- Para enfatizar el papel de las imágenes avanzadas en el diagnóstico.
Principales métodos:
- Informe de caso detallado de un recién nacido con síntomas sugerentes inicialmente de EHI.
- Iniciación de la hipotermia terapéutica (TH) basada en la presentación clínica y la actividad convulsiva.
- Diagnóstico por resonancia magnética (MRI) del cerebro para confirmar el diagnóstico.
Principales resultados:
- El recién nacido presentaba una baja puntuación de Apgar y acidosis metabólica, inicialmente tratado por sospecha de EHI.
- Las convulsiones focales a las 7 horas de vida provocaron el inicio de TH.
- La resonancia cerebral reveló un infarto subaguda en el área de la arteria cerebral posterior izquierda con componente hemorrágico.
Conclusiones:
- El accidente cerebrovascular perinatal y la EHI comparten presentaciones iniciales similares, lo que complica el diagnóstico temprano.
- La hipotermia terapéutica (TH) es una intervención razonable dada la superposición de síntomas.
- Las herramientas de puntuación para la interpretación de la resonancia magnética pueden ayudar a diferenciar la EHI del accidente cerebrovascular y mejorar el pronóstico.
Palabras clave:
Encefalopatía hipóxica isquémicaEncefalopatía neonatalApoplejía perinatalhipotermia terapéuticaMás Videos Relacionados
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