Shibani Mehra
Post Graduate Institute of Medical Education And Research, India
Title: MR diagnosis of hypoxemic-ischemic Encephalopathy in Infants and Neonates
Biography
Biography: Shibani Mehra
Abstract
A global reduction in cerebral blood flow in infants and neonates results in reduced oxygen and glucose supply to the brain which induces brain damage. This results in hypoxic-ischemic encephalopathy in the affected infants. The cerebral manifestations of HIE depend on the period during which ischemic insult occurs, the duration and severity of ischemia. Therefore in preterm infants the peri ventricular white matter ,which happens to be the vascular water shed zone in the developing fetus and is the region of high metabolic demand due to ongoing myelination, is extremely susceptible to ischemic injury.
When ischemia occurs in the term infants on the other hand, cortical and sub cortical injury is more common with lesser degree of hypoxia; while severe hypoxias involves the deep gray matter of thalamus and basal ganglia.
MR imaging is the best modality available today to evaluate infants and neonates of suspected cerebral ischemic injury. Conventional MRI sequences have an established role in detecting both acute and chronic changes of cerebral ischemia. Of late, diffusion MR has shown high sensitivity in detecting acute ischemic changes in the brain parenchyma.
MR imaging diagnoses the extent of damage in the brain, the site of involvement, differentiates between acute and chronic changes in the brain, thereby assisting in prognosticating the clinical course in patients of Hypoxic ischemic encephalopathy. I shall be discussing the spectrum of changes of hypoxic ischemia in pediatric neonatal population on MR imaging.