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Neonatal Hypoxia-Ischemia

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Clinical Neuroradiology

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.

This publication is endorsed by: European Society of Neuroradiology (www.esnr.org).

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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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Authors and Affiliations

  1. Department of Clinical Radiology and Imaging, Medical School, University of Ioannina, Ioannina, Greece

    Maria I. Argyropoulou, Vasiliki C. Mouka & Vasileios G. Xydis

Authors
  1. Maria I. Argyropoulou
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  2. Vasiliki C. Mouka
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  3. Vasileios G. Xydis
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Corresponding author

Correspondence to Maria I. Argyropoulou .

Editor information

Editors and Affiliations

  1. Department of Radiology and Nuclear Medicine, VU University Medical Centre (VUmc), Amsterdam, The Netherlands

    Frederik Barkhof

  2. The National Hospital for Neurology and Neurosurgery and University College Hospital (UCH), UCL Institute of Neurology, London, UK

    Hans Rolf Jäger

  3. Section of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, University Hospital Vienna, Vienna, Austria

    Majda M. Thurnher

  4. Department of Radiology and Nuclear Medicine Vall d’Hebron University Hospital Professor of Radiology and Neuroimmunology, Autonomous University of Barcelona Vall d’Hebron Research Institute (VHIR), Barcelona, Spain

    Àlex Rovira

Section Editor information

  1. IRCCS Istituto Giannina Gaslini Children’s Hospital, Genoa, Italy

    Andrea Rossi

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Argyropoulou, M.I., Mouka, V.C., Xydis, V.G. (2019). Neonatal Hypoxia-Ischemia. In: Barkhof, F., Jäger, H., Thurnher, M., Rovira, À. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-68536-6_31

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  • DOI: https://doi.org/10.1007/978-3-319-68536-6_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68535-9

  • Online ISBN: 978-3-319-68536-6

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