White Matter and Cortical Injury in Hypoxic-Ischemic Encephalopathy: Antecedent Factors and 2-Year Outcome
The Journal of Pediatrics, 06/15/2012
Martinez–Biarge M et al. – Infants with hypoxic–ischemic encephalopathy (HIE) and selective WM/cortical injury have a low prevalence of cerebral palsy but have a wide range of other problems, which occur more often with severe WM/cortical lesions.Methods
- From 1992-2007, 84 term infants with HIE and normal basal ganglia and thalami on neonatal magnetic resonance imaging were studied; WM/cortical lesions were classified by site and severity.
- Neurodevelopmental outcomes and head growth were documented at a median age of 2 years.
- The WM was normal or mildly abnormal in 33.5%, moderate in 40.5%, and severely abnormal in 26% of infants.
- Cortical involvement was not seen or was only mild in 75.5%, moderate in 13%, and severe in 12% of infants.
- WM and cortical injury severity were highly correlated.
- Infants with severe WM injury had more severe neonatal courses and a higher incidence of hypoglycemia. No infant died.
- Five infants (6%) developed cerebral palsy but all could walk independently.
- Cognitive, visual, language, behavioral, and seizure problems were highly prevalent and correlated significantly with the severity of WM injury and poor postnatal head growth.