MedStar Authors catalog › Details for: Brain perfusion in encephalopathic newborns after therapeutic hypothermia.
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Brain perfusion in encephalopathic newborns after therapeutic hypothermia.

by Chang, Taeun; du Plessis, Adre J.
Citation: Ajnr: American Journal of Neuroradiology. 34(8):1649-55, 2013 Aug..Journal: AJNR. American journal of neuroradiology.ISSN: 0195-6108.Full author list: Massaro AN; Bouyssi-Kobar M; Chang T; Vezina LG; du Plessis AJ; Limperopoulos C.UI/PMID: 23493898.Subject(s): Blood Flow Velocity | *Brain/pa [Pathology] | *Brain/pp [Physiopathology] | *Cerebrovascular Circulation | Female | Humans | *Hypothermia, Induced/mt [Methods] | Hypoxia-Ischemia, Brain/pa [Pathology] | *Hypoxia-Ischemia, Brain/pp [Physiopathology] | *Hypoxia-Ischemia, Brain/th [Therapy] | Infant, Newborn | Male | Reproducibility of Results | Sensitivity and Specificity | Treatment OutcomeInstitution(s): MedStar Washington Hospital CenterDepartment(s): Neonatology and PediatricsActivity type: Journal Article.Medline article type(s): Journal Article | Randomized Controlled Trial | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tDigital Object Identifier: (Click here) Abbreviated citation: AJNR Am J Neuroradiol. 34(8):1649-55, 2013 Aug.Local Holdings: Available online from MWHC library: 1995 - present (after 18 months).Abstract: BACKGROUND AND PURPOSE: Cerebral perfusion patterns in neonates with HIE after therapeutic hypothermia have not been well described. The objectives of this study were to compare global and regional perfusion between infants with HIE and neonate controls and to relate measures of cerebral perfusion to brain injury on conventional MR imaging in neonates with HIE.Abstract: MATERIALS AND METHODS: Term encephalopathic neonates meeting criteria for hypothermia between June 2011 and January 2012 were enrolled in this prospective observational study. MR imaging-ASL was performed in the second week of life. Comparisons were made with data from neonate controls who underwent the same imaging protocol. NIRS measures of cerebral oxygenation during and immediately after hypothermia were also evaluated in a subset of patients. Secondary analyses were performed to assess cerebral perfusion and oxygenation differences by pattern of injury on qualitative MR imaging interpretation.Abstract: RESULTS: We enrolled 18 infants with HIE and 18 control infants. Mean global CBF and regional CBF in the basal ganglia, thalamus, and anterior white matter were higher in cases compared with controls. Infants with HIE with injury on MR imaging, however, had lower CBF (significant in the thalamus) compared with those with normal MR imaging. Decreased FTOE by NIRS further differentiated patients with HIE with injury on MR imaging.Abstract: CONCLUSIONS: Disturbed cerebral perfusion is observed in the second week of life in some babies with HIE despite treatment with hypothermia. Infants with HIE with injury on MR imaging have lower regional CBF in the thalamus compared with those without injury, possibly representing pseudonormalization of CBF and low metabolic demand after progression to irreversible brain injury.

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