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Pediatrics
Diagnosis
Brain
Pathology-Based Diagnoses
Stroke
Hypoxic-Ischemic Encephalopathy
Hypoxic-Ischemic Encephalopathy
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Hypoxic ischemic injury, hypoxic-ischemic brain damage, neonatal asphyxia

            • Definitions

              • Hypoxic ischemic encephalopathy (HIE): Neonatal brain injury caused by perinatal hypoxic ischemic insult

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Charon V et al: Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods. Pediatr Radiol. 45(13):1988-2000, 2015
                                      2. De Vis JB et al: Arterial spin-labelling perfusion MRI and outcome in neonates with hypoxic-ischemic encephalopathy. Eur Radiol. 25(1):113-21, 2015
                                      3. Shankaran S et al: Neonatal magnetic resonance imaging pattern of brain injury as a biomarker of childhood outcomes following a trial of hypothermia for neonatal hypoxic-ischemic Encephalopathy. J Pediatr. 167(5):987-93.e3, 2015
                                      4. Cavalleri F et al: Prognostic value of diffusion-weighted imaging summation scores or apparent diffusion coefficient maps in newborns with hypoxic-ischemic encephalopathy. Pediatr Radiol. Epub ahead of print, 2014
                                      5. Ancora G et al: Prognostic value of brain proton MR spectroscopy and diffusion tensor imaging in newborns with hypoxic-ischemic encephalopathy treated by brain cooling. Neuroradiology. 55(8):1017-25, 2013
                                      6. Harteman JC et al: Placental pathology in full-term infants with hypoxic-ischemic neonatal encephalopathy and association with magnetic resonance imaging pattern of brain injury. J Pediatr. 163(4):968-95.e2, 2013
                                      7. Jose A et al: Correlation of EEG, CT, and MRI brain with neurological outcome at 12 months in term newborns with hypoxic ischemic encephalopathy. J Clin Neonatol. 2(3):125-30, 2013
                                      8. Srinivasakumar P et al: Therapeutic hypothermia in neonatal hypoxic ischemic encephalopathy: electrographic seizures and magnetic resonance imaging evidence of injury. J Pediatr. 163(2):465-70, 2013
                                      9. Bednarek N et al: Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy. Neurology. 78(18):1420-7, 2012
                                      10. Mulkey SB et al: Quantitative cranial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy. Pediatr Neurol. 47(2):101-8, 2012
                                      11. Glass HC et al: Seizures and magnetic resonance imaging-detected brain injury in newborns cooled for hypoxic-ischemic encephalopathy. J Pediatr. 159(5):731-735.e1, 2011
                                      12. Izbudak I et al: MR imaging of the term and preterm neonate with diffuse brain injury. Magn Reson Imaging Clin N Am. 19(4):709-31; vii, 2011
                                      13. Griffiths PD et al: Anatomic localization of dyskinesia in children with "profound" perinatal hypoxic-ischemic injury. AJNR Am J Neuroradiol. 31(3):436-41, 2010
                                      14. Logitharajah P et al: Hypoxic-ischemic encephalopathy in preterm infants: antecedent factors, brain imaging, and outcome. Pediatr Res. 66(2):222-9, 2009
                                      15. Okereafor A et al: Patterns of brain injury in neonates exposed to perinatal sentinel events. Pediatrics. 121(5):906-14, 2008
                                      16. Winter JD et al: Apparent diffusion coefficient pseudonormalization time in neonatal hypoxic-ischemic encephalopathy. Pediatr Neurol. 37(4):255-62, 2007
                                      17. Barkovich AJ et al: MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. AJNR Am J Neuroradiol. 27(3):533-47, 2006
                                      18. Miller SP et al: Patterns of brain injury in term neonatal encephalopathy. J Pediatr. 146(4):453-60, 2005
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Hypoxic ischemic injury, hypoxic-ischemic brain damage, neonatal asphyxia

                                                • Definitions

                                                  • Hypoxic ischemic encephalopathy (HIE): Neonatal brain injury caused by perinatal hypoxic ischemic insult

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Charon V et al: Comparison of early and late MRI in neonatal hypoxic-ischemic encephalopathy using three assessment methods. Pediatr Radiol. 45(13):1988-2000, 2015
                                                                          2. De Vis JB et al: Arterial spin-labelling perfusion MRI and outcome in neonates with hypoxic-ischemic encephalopathy. Eur Radiol. 25(1):113-21, 2015
                                                                          3. Shankaran S et al: Neonatal magnetic resonance imaging pattern of brain injury as a biomarker of childhood outcomes following a trial of hypothermia for neonatal hypoxic-ischemic Encephalopathy. J Pediatr. 167(5):987-93.e3, 2015
                                                                          4. Cavalleri F et al: Prognostic value of diffusion-weighted imaging summation scores or apparent diffusion coefficient maps in newborns with hypoxic-ischemic encephalopathy. Pediatr Radiol. Epub ahead of print, 2014
                                                                          5. Ancora G et al: Prognostic value of brain proton MR spectroscopy and diffusion tensor imaging in newborns with hypoxic-ischemic encephalopathy treated by brain cooling. Neuroradiology. 55(8):1017-25, 2013
                                                                          6. Harteman JC et al: Placental pathology in full-term infants with hypoxic-ischemic neonatal encephalopathy and association with magnetic resonance imaging pattern of brain injury. J Pediatr. 163(4):968-95.e2, 2013
                                                                          7. Jose A et al: Correlation of EEG, CT, and MRI brain with neurological outcome at 12 months in term newborns with hypoxic ischemic encephalopathy. J Clin Neonatol. 2(3):125-30, 2013
                                                                          8. Srinivasakumar P et al: Therapeutic hypothermia in neonatal hypoxic ischemic encephalopathy: electrographic seizures and magnetic resonance imaging evidence of injury. J Pediatr. 163(2):465-70, 2013
                                                                          9. Bednarek N et al: Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy. Neurology. 78(18):1420-7, 2012
                                                                          10. Mulkey SB et al: Quantitative cranial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy. Pediatr Neurol. 47(2):101-8, 2012
                                                                          11. Glass HC et al: Seizures and magnetic resonance imaging-detected brain injury in newborns cooled for hypoxic-ischemic encephalopathy. J Pediatr. 159(5):731-735.e1, 2011
                                                                          12. Izbudak I et al: MR imaging of the term and preterm neonate with diffuse brain injury. Magn Reson Imaging Clin N Am. 19(4):709-31; vii, 2011
                                                                          13. Griffiths PD et al: Anatomic localization of dyskinesia in children with "profound" perinatal hypoxic-ischemic injury. AJNR Am J Neuroradiol. 31(3):436-41, 2010
                                                                          14. Logitharajah P et al: Hypoxic-ischemic encephalopathy in preterm infants: antecedent factors, brain imaging, and outcome. Pediatr Res. 66(2):222-9, 2009
                                                                          15. Okereafor A et al: Patterns of brain injury in neonates exposed to perinatal sentinel events. Pediatrics. 121(5):906-14, 2008
                                                                          16. Winter JD et al: Apparent diffusion coefficient pseudonormalization time in neonatal hypoxic-ischemic encephalopathy. Pediatr Neurol. 37(4):255-62, 2007
                                                                          17. Barkovich AJ et al: MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. AJNR Am J Neuroradiol. 27(3):533-47, 2006
                                                                          18. Miller SP et al: Patterns of brain injury in term neonatal encephalopathy. J Pediatr. 146(4):453-60, 2005