TY  - BOOK
AU  - Chang, Taeun
AU  - du Plessis, Adre J
TI  - Brain perfusion in encephalopathic newborns after therapeutic hypothermia
SN  - 0195-6108
PY  - 2013///
KW  - *Brain/pa [Pathology]
KW  - *Brain/pp [Physiopathology]
KW  - *Cerebrovascular Circulation
KW  - *Hypothermia, Induced/mt [Methods]
KW  - *Hypoxia-Ischemia, Brain/pp [Physiopathology]
KW  - *Hypoxia-Ischemia, Brain/th [Therapy]
KW  - Blood Flow Velocity
KW  - Female
KW  - Humans
KW  - Hypoxia-Ischemia, Brain/pa [Pathology]
KW  - Infant, Newborn
KW  - Male
KW  - Reproducibility of Results
KW  - Sensitivity and Specificity
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Neonatology and Pediatrics
KW  - Journal Article
KW  - Randomized Controlled Trial
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1995 - present (after 18 months)
N2  - 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; 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; 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; 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
UR  - http://dx.doi.org/10.3174/ajnr.A3422
ER  -