Abstract
Perinatal ischemic brain injury may appear in premature and full-term babies and includes global hypoxic-ischemic encephalopathy (HIE) and perinatal stroke. The symptoms are similar and non-specific, and clinical neuroradiology plays an important role in defining the diagnosis, following up the patient, and determining the effect on maturation and prognosis. Radiological techniques include state-of-the-art brain ultrasound (US) coupled with color Doppler for the initial diagnostic approach and magnetic resonance imaging (MRI) with T1- and T2-weighted sequences, diffusion-weighted (DWI), or diffusion tensor imaging (DTI). Depending on the suspected pathology, susceptibility-weighted imaging (SWI) and perfusion imaging using arterial spin labeling (ASL) may also be applied. Mild to moderate HIE in full-term babies comprises parasagittal cortico-subcortical lesions in arterial watershed zones, while in premature babies, it manifests as periventricular leukomalacia (PVL), either focal or diffuse. In severe HIE in both full-term and premature babies, a “central” pattern of lesions develops in the areas most mature for age, and in the most severe cases of HIE, the whole brain is affected. Brain hemorrhagic disease (BHD) develops mainly in very premature babies and includes subependymal and intraventricular hemorrhage (IVH). Posthemorrhagic hydrocephalus and periventricular hemorrhagic infarction (PHI) may also occur. Perinatal stroke is classified into arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT). AIS develops in full-term and near-term babies and involves mainly the left middle cerebral artery (MCA) territory. CSVT affects mainly the superficial venous system and is associated with hemorrhagic infarcts.
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Abbreviations
- ADC:
-
Apparent diffusion coefficient
- AIS:
-
Arterial ischemic stroke
- ASL:
-
Arterial spin labeling
- ATP:
-
Adenosine triphosphate
- BHD:
-
Brain hemorrhagic disease
- CBF:
-
Cerebral blood flow
- CSF:
-
Cerebrospinal fluid
- CSVT:
-
Cerebral sinovenous thrombosis
- DMV:
-
Deep medullary veins
- DTI:
-
Diffusion tensor imaging
- DWI:
-
Diffusion-weighted imaging
- ELBW:
-
Extremely low birth weight
- GABA:
-
Gamma-aminobutyric acid
- GMH:
-
Germinal matrix hemorrhage
- HIE:
-
Hypoxic-ischemic encephalopathy
- MCA:
-
Middle cerebral artery
- MRA:
-
Magnetic resonance angiography
- MRI:
-
Magnetic resonance imaging
- OLp:
-
Oligodendroglia precursors
- PC:
-
Phase contrast
- PHI:
-
Periventricular hemorrhagic infarction
- PLIC:
-
Posterior limb of the internal capsule
- PVL:
-
Periventricular leukomalacia
- RI:
-
Resistive index
- SWI:
-
Susceptibility-weighted imaging
- T1-W:
-
T1 weighted
- T2-W:
-
T2 weighted
- TOF:
-
Time-of-flight
- US:
-
Ultrasound
- VLBW:
-
Very low birth weight
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Argyropoulou, M.I., Mouka, V.C., Xydis, V.G. (2019). Neonatal Hypoxia-Ischemia. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_31-1
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DOI: https://doi.org/10.1007/978-3-319-61423-6_31-1
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