American Journal of Neuroradiology, Vol 16, Issue 9 1837-1846, Copyright © 1995 by American Society of Neuroradiology
ARTICLES |
Profound asphyxia in the premature infant: imaging findings
AJ Barkovich and SK Sargent
Department of Radiology, University of California, San Francisco 94143- 0628, USA.
PURPOSE: To investigate imaging findings in premature infants who had profound asphyxia. METHODS: CT (three patients), MR (three patients), and ultrasonography (four patients) studies of five patients who had profound asphyxia before the postconceptional age of 32 weeks were retrospectively reviewed. The patients ranged from 1 day to 4 months old at the time of the imaging studies. An autopsy report was available in one patient. The results were compared with reports in the literature of patients with similar injuries at similar ages. RESULTS: Abnormalities of the thalami and basal ganglia were present in all infants examined with CT or MR. CT showed low attenuation in the basal ganglia and high attenuation (blood or calcium) in the thalami; thalamic cavitation and low attenuation of the upper brain stem were present in one infant. MR showed T1 and T2 shortening in the thalami in all patients. Variable MR changes were noted in the basal ganglia, ranging from diminished size with normal signal intensity to T1 and T2 shortening with normal size and complete cavitation. T1 and T2 shortening were seen in the dorsal brain stem in one patient. Sonography showed transient or persistent hyperechogenicity in the thalami in three patients and cavitation of the thalami in one patient. Damage to the perirolandic cortex was not present in any patient. CONCLUSION: Profound asphyxia before 32 weeks gestational age shows consistent injury to the thalami, basal ganglia, and brain stem that can be detected by all three imaging modalities. The pattern of injury seems to differ from that of partial asphyxia in premature infants and of profound asphyxia in term infants.
This article has been cited by other articles:
 |
|
 |
|
  L. Liauw, J. van der Grond, A. A. van den Berg-Huysmans, I. H. Palm-Meinders, M. A. van Buchem, and G. van Wezel-Meijler Hypoxic-Ischemic Encephalopathy: Diagnostic Value of Conventional MR Imaging Pulse Sequences in Term-born Neonates Radiology, April 1, 2008; 247(1): 204 - 212. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C Heathcock, M. Lobo, and J. C Galloway Movement Training Advances the Emergence of Reaching in Infants Born at Less Than 33 Weeks of Gestational Age: A Randomized Clinical Trial Physical Therapy, March 1, 2008; 88(3): 310 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Y. Huang and M. Castillo Hypoxic-Ischemic Brain Injury: Imaging Findings from Birth to Adulthood RadioGraphics, March 1, 2008; 28(2): 417 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Liauw, I.H. Palm-Meinders, J. van der Grond, L.M. Leijser, S. le Cessie, L.A.E.M. Laan, B.C. Heeres, M.A. van Buchem, and G. van Wezel-Meijler Differentiating Normal Myelination from Hypoxic-Ischemic Encephalopathy on T1-Weighted MR Images: A New Approach AJNR Am. J. Neuroradiol., April 1, 2007; 28(4): 660 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fraser, L. Bennet, R. Helliwell, S. Wells, C. Williams, P. Gluckman, A. J. Gunn, and T. Inder Regional Specificity of Magnetic Resonance Imaging and Histopathology Following Cerebral Ischemia in Preterm Fetal Sheep Reproductive Sciences, February 1, 2007; 14(2): 182 - 191. [Abstract] [PDF]
|
|
|
|
 |
|
 L. Bennet, V. Roelfsema, S. George, J. M. Dean, B. S. Emerald, and A. J. Gunn The effect of cerebral hypothermia on white and grey matter injury induced by severe hypoxia in preterm fetal sheep J. Physiol., January 15, 2007; 578(2): 491 - 506. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Bennet, J. M. Dean, G. Wassink, and A. J. Gunn Differential Effects of Hypothermia on Early and Late Epileptiform Events After Severe Hypoxia in Preterm Fetal Sheep J Neurophysiol, January 1, 2007; 97(1): 572 - 578. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. P. Chao, C. G. Zaleski, and A. C. Patton Neonatal Hypoxic-Ischemic Encephalopathy: Multimodality Imaging Findings RadioGraphics, October 1, 2006; 26(suppl_1): S159 - S172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Bennet, V. Roelfsema, P. Pathipati, J. S. Quaedackers, and A. J. Gunn Relationship between evolving epileptiform activity and delayed loss of mitochondrial activity after asphyxia measured by near-infrared spectroscopy in preterm fetal sheep J. Physiol., April 1, 2006; 572(1): 141 - 154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.J. Barkovich, S.P. Miller, A. Bartha, N. Newton, S.E.G. Hamrick, P. Mukherjee, O.A. Glenn, D. Xu, J.C. Partridge, D.M. Ferriero, et al. MR Imaging, MR Spectroscopy, and Diffusion Tensor Imaging of Sequential Studies in Neonates with Encephalopathy AJNR Am. J. Neuroradiol., March 1, 2006; 27(3): 533 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Rutherford, D. Azzopardi, A. Whitelaw, F. Cowan, S. Renowden, A. D. Edwards, and M. Thoresen Mild Hypothermia and the Distribution of Cerebral Lesions in Neonates With Hypoxic-Ischemic Encephalopathy Pediatrics, October 1, 2005; 116(4): 1001 - 1006. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. George, A. J. Gunn, J. A. Westgate, C. Brabyn, J. Guan, and L. Bennet Fetal heart rate variability and brain stem injury after asphyxia in preterm fetal sheep Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2004; 287(4): R925 - R933. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. S. Peterson, A. W. Anderson, R. Ehrenkranz, L. H. Staib, M. Tageldin, E. Colson, J. C. Gore, C. C. Duncan, R. Makuch, and L. R. Ment Regional Brain Volumes and Their Later Neurodevelopmental Correlates in Term and Preterm Infants Pediatrics, May 1, 2003; 111(5): 939 - 948. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Barkovich, K. D. Westmark, H. S. Bedi, J. C. Partridge, D. M. Ferriero, and D. B. Vigneron Proton Spectroscopy and Diffusion Imaging on the First Day of Life after Perinatal Asphyxia: Preliminary Report AJNR Am. J. Neuroradiol., October 1, 2001; 22(9): 1786 - 1794. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Coskun, M. Lequin, M. Segal, D. B. Vigneron, D. M. Ferriero, and A. J. Barkovich Quantitative Analysis of MR Images in Asphyxiated Neonates: Correlation with Neurodevelopmental Outcome AJNR Am. J. Neuroradiol., February 1, 2001; 22(2): 400 - 405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. T. L. Sie, M. S. van der Knaap, G. van Wezel-Meijler, A. H. M. Taets van Amerongen, H. N. Lafeber, and J. Valk Early MR Features of Hypoxic-ischemic Brain Injury in Neonates with Periventricular Densities on Sonograms AJNR Am. J. Neuroradiol., May 1, 2000; 21(5): 852 - 861. [Abstract] [Full Text]
|
|
|
|
|
|
E. Ralph Heinz In Re: Barkovich AJ.MR and CT evaluation of profound neonatal and infantile asphyxia.AJNR Am J Neuroradiol 1992;13:959-972 AJNR Am. J. Neuroradiol., May 1, 2000; 21(5): 979 - 981. [Full Text]
|
|
|
|
|
|
W. S. Ball Jr PEDIATRIC NEURORADIOLOGY AJNR Am. J. Neuroradiol., January 1, 2000; 21(1): 29 - 36. [Full Text] [PDF]
|
|
|
|
|
|
U. Felderhoff-Mueser, M. A. Rutherford, W. V. Squier, P. Cox, E. F. Maalouf, S. J. Counsell, G. M. Bydder, and A. D. Edwards Relationship between MR Imaging and Histopathologic Findings of the Brain in Extremely Sick Preterm Infants AJNR Am. J. Neuroradiol., August 1, 1999; 20(7): 1349 - 1357. [Abstract] [Full Text]
|
|