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Erschienen in: Pediatric Radiology 5/2012

01.05.2012 | Pictorial Essay

Neonatal ischemic brain injury: what every radiologist needs to know

verfasst von: Chaitra A. Badve, Paritosh C. Khanna, Gisele E. Ishak

Erschienen in: Pediatric Radiology | Ausgabe 5/2012

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Abstract

We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist’s perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested.
Literatur
1.
Zurück zum Zitat Yang Z, Covey MV, Bitel CL et al (2007) Sustained neocortical neurogenesis after neonatal hypoxic/ischemic injury. Ann Neurol 61:199–208PubMedCrossRef Yang Z, Covey MV, Bitel CL et al (2007) Sustained neocortical neurogenesis after neonatal hypoxic/ischemic injury. Ann Neurol 61:199–208PubMedCrossRef
3.
5.
Zurück zum Zitat Wu YW, Backstrand KH, Zhao S et al (2004) Declining diagnosis of birth asphyxia in California: 1991–2000. Pediatrics 114:1584–1590PubMedCrossRef Wu YW, Backstrand KH, Zhao S et al (2004) Declining diagnosis of birth asphyxia in California: 1991–2000. Pediatrics 114:1584–1590PubMedCrossRef
6.
Zurück zum Zitat Smith J, Wells L, Dodd K (2000) The continuing fall in incidence of hypoxic-ischemic encephalopathy in term infants. BJOG 107:461–466PubMedCrossRef Smith J, Wells L, Dodd K (2000) The continuing fall in incidence of hypoxic-ischemic encephalopathy in term infants. BJOG 107:461–466PubMedCrossRef
7.
Zurück zum Zitat Perlman JM (1997) Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Pediatrics 99:851–859PubMedCrossRef Perlman JM (1997) Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Pediatrics 99:851–859PubMedCrossRef
8.
Zurück zum Zitat deVeber G, Andrew M, Adams C et al (2001) Cerebral sinovenous thrombosis in children. N Engl J Med 345:417–423PubMedCrossRef deVeber G, Andrew M, Adams C et al (2001) Cerebral sinovenous thrombosis in children. N Engl J Med 345:417–423PubMedCrossRef
9.
10.
Zurück zum Zitat Volpe JJ (2009) Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol 8:110–124PubMedCrossRef Volpe JJ (2009) Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol 8:110–124PubMedCrossRef
11.
Zurück zum Zitat Shalak L, Perlman JM (2004) Hypoxic-ischemic brain injury in the term infant—current concepts. Early Hum Dev 80:125–141PubMedCrossRef Shalak L, Perlman JM (2004) Hypoxic-ischemic brain injury in the term infant—current concepts. Early Hum Dev 80:125–141PubMedCrossRef
12.
Zurück zum Zitat Daneman A, Epelman M, Blaser S et al (2006) Imaging of the brain in full-term neonates: does sonography still play a role? Pediatr Radiol 36:636–646PubMedCrossRef Daneman A, Epelman M, Blaser S et al (2006) Imaging of the brain in full-term neonates: does sonography still play a role? Pediatr Radiol 36:636–646PubMedCrossRef
13.
Zurück zum Zitat Epelman M, Daneman A, Kellenberger CJ et al (2010) Neonatal encephalopathy: a prospective comparison of head US and MRI. Pediatr Radiol 40:1640–1650PubMedCrossRef Epelman M, Daneman A, Kellenberger CJ et al (2010) Neonatal encephalopathy: a prospective comparison of head US and MRI. Pediatr Radiol 40:1640–1650PubMedCrossRef
14.
Zurück zum Zitat Blankenberg FG, Loh NN, Bracci P et al (2000) Sonography, CT, and MR imaging: a prospective comparison of neonates with suspected intracranial ischemia and hemorrhage. AJNR 21:213–218PubMed Blankenberg FG, Loh NN, Bracci P et al (2000) Sonography, CT, and MR imaging: a prospective comparison of neonates with suspected intracranial ischemia and hemorrhage. AJNR 21:213–218PubMed
15.
Zurück zum Zitat Chau V, Poskitt KJ, Sargent MA et al (2009) Comparison of computer tomography and magnetic resonance imaging scans on the third day of life in term newborns with neonatal encephalopathy. Pediatrics 123:319–326PubMedCrossRef Chau V, Poskitt KJ, Sargent MA et al (2009) Comparison of computer tomography and magnetic resonance imaging scans on the third day of life in term newborns with neonatal encephalopathy. Pediatrics 123:319–326PubMedCrossRef
16.
Zurück zum Zitat Lequin MH, Dudink J, Tong KA et al (2009) Magnetic resonance imaging in neonatal stroke. Semin Fetal Neonatal Med 14:299–310PubMedCrossRef Lequin MH, Dudink J, Tong KA et al (2009) Magnetic resonance imaging in neonatal stroke. Semin Fetal Neonatal Med 14:299–310PubMedCrossRef
17.
Zurück zum Zitat Shroff MM, Soares-Fernandes JP, Whyte H et al (2010) MR imaging for diagnostic evaluation of encephalopathy in the newborn. Radiographics 30:763–780PubMedCrossRef Shroff MM, Soares-Fernandes JP, Whyte H et al (2010) MR imaging for diagnostic evaluation of encephalopathy in the newborn. Radiographics 30:763–780PubMedCrossRef
18.
Zurück zum Zitat Hanrahan JD, Sargentoni J, Azzopardi D et al (1996) Cerebral metabolism within 18 hours of birth asphyxia: a proton magnetic resonance spectroscopy study. Pediatr Res 39:584–590PubMedCrossRef Hanrahan JD, Sargentoni J, Azzopardi D et al (1996) Cerebral metabolism within 18 hours of birth asphyxia: a proton magnetic resonance spectroscopy study. Pediatr Res 39:584–590PubMedCrossRef
19.
Zurück zum Zitat de Vries LS, Groenendaal F (2010) Patterns of neonatal hypoxic-ischaemic brain injury. Neuroradiology 52:555–566PubMedCrossRef de Vries LS, Groenendaal F (2010) Patterns of neonatal hypoxic-ischaemic brain injury. Neuroradiology 52:555–566PubMedCrossRef
20.
Zurück zum Zitat Penrice J, Cady EB, Lorek A et al (1996) Proton magnetic resonance spectroscopy of the brain in normal preterm and term infants, and early changes after perinatal hypoxia-ischemia. Pediatr Res 40:6–14PubMedCrossRef Penrice J, Cady EB, Lorek A et al (1996) Proton magnetic resonance spectroscopy of the brain in normal preterm and term infants, and early changes after perinatal hypoxia-ischemia. Pediatr Res 40:6–14PubMedCrossRef
21.
Zurück zum Zitat Volpe JJ (2003) Cerebral white matter injury of the premature infant—more common than you think. Pediatrics 112:1–7CrossRef Volpe JJ (2003) Cerebral white matter injury of the premature infant—more common than you think. Pediatrics 112:1–7CrossRef
22.
Zurück zum Zitat Berfelo FJ, Kersbergen KJ, van Ommen CH et al (2010) Neonatal cerebral sinovenous thrombosis from symptom to outcome. Stroke 41:1382–1388PubMedCrossRef Berfelo FJ, Kersbergen KJ, van Ommen CH et al (2010) Neonatal cerebral sinovenous thrombosis from symptom to outcome. Stroke 41:1382–1388PubMedCrossRef
23.
Zurück zum Zitat Groenendaal F, Benders MJ, de Vries LS (2006) Pre-wallerian degeneration in the neonatal brain following perinatal cerebral hypoxia-ischemia demonstrated with MRI. Sem Perinatol 30:146–150CrossRef Groenendaal F, Benders MJ, de Vries LS (2006) Pre-wallerian degeneration in the neonatal brain following perinatal cerebral hypoxia-ischemia demonstrated with MRI. Sem Perinatol 30:146–150CrossRef
24.
Zurück zum Zitat Wu YW, Lindan CE, Henning LH et al (2006) Neuroimaging abnormalities in infants with congenital hemiparesis. Pediatr Neurol 35:191–196PubMedCrossRef Wu YW, Lindan CE, Henning LH et al (2006) Neuroimaging abnormalities in infants with congenital hemiparesis. Pediatr Neurol 35:191–196PubMedCrossRef
25.
Zurück zum Zitat Eichler F, Krishnamoorthy K, Grant PE (2007) Magnetic resonance imaging evaluation of possible neonatal sinovenous thrombosis. Pediatr Neurol 37:317–323PubMedCrossRef Eichler F, Krishnamoorthy K, Grant PE (2007) Magnetic resonance imaging evaluation of possible neonatal sinovenous thrombosis. Pediatr Neurol 37:317–323PubMedCrossRef
26.
Zurück zum Zitat Wu YW, Hamrick SE, Miller SP et al (2003) Intraventricular hemorrhage in term neonates caused by sinovenous thrombosis. Ann Neurol 54:123–126PubMedCrossRef Wu YW, Hamrick SE, Miller SP et al (2003) Intraventricular hemorrhage in term neonates caused by sinovenous thrombosis. Ann Neurol 54:123–126PubMedCrossRef
27.
Zurück zum Zitat Ramenghi LA, Govaert P, Fumagalli M et al (2009) Neonatal cerebral sinovenous thrombosis. Sem Fetal Neonatal Med 14:278–283CrossRef Ramenghi LA, Govaert P, Fumagalli M et al (2009) Neonatal cerebral sinovenous thrombosis. Sem Fetal Neonatal Med 14:278–283CrossRef
28.
Zurück zum Zitat McKinney AM, Thompson LR, Truwit CL et al (2008) Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury. Pediatr Radiol 38:164–174PubMedCrossRef McKinney AM, Thompson LR, Truwit CL et al (2008) Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury. Pediatr Radiol 38:164–174PubMedCrossRef
29.
Zurück zum Zitat Shaw DW, Cohen WA (1993) Viral infections of the CNS in children: imaging features. AJR 160:125–133PubMed Shaw DW, Cohen WA (1993) Viral infections of the CNS in children: imaging features. AJR 160:125–133PubMed
30.
Zurück zum Zitat Barkovich AJ, Ali FA, Rowley HA et al (1998) Imaging patterns of neonatal hypoglycemia. AJNR 19:523–528PubMed Barkovich AJ, Ali FA, Rowley HA et al (1998) Imaging patterns of neonatal hypoglycemia. AJNR 19:523–528PubMed
31.
Zurück zum Zitat Jan W, Zimmerman RA, Wang ZJ et al (2003) MR diffusion imaging and MR spectroscopy of maple syrup urine disease during acute metabolic decompensation. Neuroradiology 45:393–399PubMedCrossRef Jan W, Zimmerman RA, Wang ZJ et al (2003) MR diffusion imaging and MR spectroscopy of maple syrup urine disease during acute metabolic decompensation. Neuroradiology 45:393–399PubMedCrossRef
32.
Zurück zum Zitat Mourmans J, Majoie CB, Barth PG et al (2006) Sequential MR imaging changes in nonketotic hyperglycemia. AJNR 27:208–211PubMed Mourmans J, Majoie CB, Barth PG et al (2006) Sequential MR imaging changes in nonketotic hyperglycemia. AJNR 27:208–211PubMed
33.
Zurück zum Zitat Barkovich AJ, Miller SP, Bartha A et al (2006) MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. AJNR 27:533–547PubMed Barkovich AJ, Miller SP, Bartha A et al (2006) MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. AJNR 27:533–547PubMed
34.
Zurück zum Zitat Rutherford M, Ramenghi LA, Edwards AD et al (2010) Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic-ischemic encephalopathy: a nested substudy of a randomized controlled trial. Lancet Neurol 9:39–45PubMedCrossRef Rutherford M, Ramenghi LA, Edwards AD et al (2010) Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic-ischemic encephalopathy: a nested substudy of a randomized controlled trial. Lancet Neurol 9:39–45PubMedCrossRef
35.
Zurück zum Zitat Farr TD, Wegener S (2010) Use of magnetic resonance imaging to predict outcome after stroke: a review of experimental and clinical evidence. J Cereb Blood Flow Metab 30:703–717PubMedCrossRef Farr TD, Wegener S (2010) Use of magnetic resonance imaging to predict outcome after stroke: a review of experimental and clinical evidence. J Cereb Blood Flow Metab 30:703–717PubMedCrossRef
36.
Zurück zum Zitat van Kooji BJ, van Handel M, Nievelstein RA et al (2010) Serial MRI and neurodevelopmental outcome in 9- to 10-year-old children with neonatal encephalopathy. J Pediatr 157:221–227CrossRef van Kooji BJ, van Handel M, Nievelstein RA et al (2010) Serial MRI and neurodevelopmental outcome in 9- to 10-year-old children with neonatal encephalopathy. J Pediatr 157:221–227CrossRef
37.
Zurück zum Zitat Boichot C, Walker PM, Durand C et al (2006) Term neonate prognoses after perinatal asphyxia: contributions of MR imaging, MR spectroscopy, relaxation times, and apparent diffusion coefficients. Radiology 239:839–848PubMedCrossRef Boichot C, Walker PM, Durand C et al (2006) Term neonate prognoses after perinatal asphyxia: contributions of MR imaging, MR spectroscopy, relaxation times, and apparent diffusion coefficients. Radiology 239:839–848PubMedCrossRef
38.
Zurück zum Zitat Rutherford M, Counsell S, Allsop J et al (2004) Diffusion-weighted magnetic resonance imaging in term perinatal brain injury: a comparison with site of lesion and time from birth. Pediatrics 114:1004–1014PubMedCrossRef Rutherford M, Counsell S, Allsop J et al (2004) Diffusion-weighted magnetic resonance imaging in term perinatal brain injury: a comparison with site of lesion and time from birth. Pediatrics 114:1004–1014PubMedCrossRef
39.
Zurück zum Zitat Liaw L, van Wezel-Meijler G, Veen S et al (2009) Do apparent diffusion coefficient measurements predict outcome in children with neonatal hypoxic-ischemic encephalopathy? AJNR 30:264–270CrossRef Liaw L, van Wezel-Meijler G, Veen S et al (2009) Do apparent diffusion coefficient measurements predict outcome in children with neonatal hypoxic-ischemic encephalopathy? AJNR 30:264–270CrossRef
40.
Zurück zum Zitat Wilkinson D (2010) MRI and withdrawal of life support from newborn infants with hypoxic- ischemic encephalopathy. Pediatrics 126:e451–e458PubMedCrossRef Wilkinson D (2010) MRI and withdrawal of life support from newborn infants with hypoxic- ischemic encephalopathy. Pediatrics 126:e451–e458PubMedCrossRef
41.
Zurück zum Zitat Ashwal S, Obenaus A, Snyder EY (2009) Neuroimaging as a basis for rational stem cell therapy. Pediatr Neurol 40:227–236PubMedCrossRef Ashwal S, Obenaus A, Snyder EY (2009) Neuroimaging as a basis for rational stem cell therapy. Pediatr Neurol 40:227–236PubMedCrossRef
42.
Zurück zum Zitat Feldman HM, Yeatman JD, Lee ES et al (2010) Diffusion tensor imaging: a review for pediatric researchers and clinicians. J Dev Behav Pediatr 31:346–356PubMedCrossRef Feldman HM, Yeatman JD, Lee ES et al (2010) Diffusion tensor imaging: a review for pediatric researchers and clinicians. J Dev Behav Pediatr 31:346–356PubMedCrossRef
43.
Zurück zum Zitat Porter EJ, Counsell SJ, Edwards AD et al (2010) Tract-based spatial statistics of magnetic resonance images to assess disease and treatment effects in perinatal asphyxia encephalopathy. Pediatr Res 68:205–209PubMedCrossRef Porter EJ, Counsell SJ, Edwards AD et al (2010) Tract-based spatial statistics of magnetic resonance images to assess disease and treatment effects in perinatal asphyxia encephalopathy. Pediatr Res 68:205–209PubMedCrossRef
44.
Zurück zum Zitat Sotak CH (2002) The role of diffusion tensor imaging in the evaluation of ischemic brain injury – a review. NMR Biomed 15:561–569PubMedCrossRef Sotak CH (2002) The role of diffusion tensor imaging in the evaluation of ischemic brain injury – a review. NMR Biomed 15:561–569PubMedCrossRef
45.
Zurück zum Zitat Kirton A, Shroff M, Visvanathan T et al (2007) Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome. Stroke 38:974–980PubMedCrossRef Kirton A, Shroff M, Visvanathan T et al (2007) Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome. Stroke 38:974–980PubMedCrossRef
46.
Zurück zum Zitat Pulg J, Pedraza S, Blasco G et al (2010) Wallerian degeneration in the corticospinal tract evaluated by diffusion tensor imaging correlates with motor deficit 30 days after middle cerebral artery ischemic stroke. AJNR 31:1324–1330CrossRef Pulg J, Pedraza S, Blasco G et al (2010) Wallerian degeneration in the corticospinal tract evaluated by diffusion tensor imaging correlates with motor deficit 30 days after middle cerebral artery ischemic stroke. AJNR 31:1324–1330CrossRef
47.
48.
Zurück zum Zitat Kloska SP, Wintermark M, Engelhorn T et al (2010) Acute stroke magnetic resonance imaging: current status and future perspective. Neuroradiology 52:189–201PubMedCrossRef Kloska SP, Wintermark M, Engelhorn T et al (2010) Acute stroke magnetic resonance imaging: current status and future perspective. Neuroradiology 52:189–201PubMedCrossRef
49.
Zurück zum Zitat Tong KA, Ashwal S, Obenaus A et al (2008) Susceptibility weighted MR imaging: a review of clinical applications in children. AJNR 29:9–17PubMedCrossRef Tong KA, Ashwal S, Obenaus A et al (2008) Susceptibility weighted MR imaging: a review of clinical applications in children. AJNR 29:9–17PubMedCrossRef
50.
Zurück zum Zitat van Laar PJ, van der Grond J, Hendrikse J (2008) Brain perfusion territory imaging: methods and clinical applications of selective arterial spin-labeling MR imaging. Radiology 246:354–364PubMedCrossRef van Laar PJ, van der Grond J, Hendrikse J (2008) Brain perfusion territory imaging: methods and clinical applications of selective arterial spin-labeling MR imaging. Radiology 246:354–364PubMedCrossRef
51.
Zurück zum Zitat Pollock JM, Tan H, Kraft RA et al (2009) Arterial spin labeled MRI perfusion imaging: clinical applications. Magn Reson Imaging Clin N Am 17:315–338PubMedCrossRef Pollock JM, Tan H, Kraft RA et al (2009) Arterial spin labeled MRI perfusion imaging: clinical applications. Magn Reson Imaging Clin N Am 17:315–338PubMedCrossRef
Metadaten
Titel
Neonatal ischemic brain injury: what every radiologist needs to know
verfasst von
Chaitra A. Badve
Paritosh C. Khanna
Gisele E. Ishak
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 5/2012
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2332-8

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