- Etiology: in term infants, 2 types of global hypoxia
— Profound hypoxia – from cardiac arrest or abruptio placenta – affects regions of highest oxygen demand: basal ganglia, ventral lateral thalami, brainstem, hippocampi, corticospinal tracts, sensorimotor cortex
— Partial hypoxia – from decreased cerebral blood flow – affects watershed regions such as periventricular white matter of premature infant (periventricular leukomalacia) or gray matter white matter junction of full term infant, seen best in parasagittal images - US: early see diffusely increased parenchymal echogenicity, later see increased echogenicity in basal ganglia
- CT: diffuse brain edema with pseudo subarachnoid hemorrhage, white cerebellar sign
- MRI: diffuse weighted imaging best performed around 4 days old, in profound hypoxia see central pattern of changes of diffusion restriction in the basal ganglia, in partial hypoxia see peripheral pattern of changes of diffusion restriction at the watershed regions
- MRI: appearance depends on severity and duration of the event
— Moderate and Brief: watershed infarctions
— Profound and Brief: basal ganglia, thalamus, perirolandic cortex
— Moderate and Prolonged: diffuse cortex (sparing perirolandic and basal ganglia)
— Profound and Prolonged: cerebral devastation - Treatment: therapeutic hypothermia for 72 hours with slow and controlled rewarming
- Clinical: symptoms are non-specific
Radiology Cases of Hypoxic Ischemic Encephalopathy
Radiology Cases of Neonatal Hypoxic Ischemic Encephalopathy



Radiology Cases of Non-Neonatal Hypoxic Ischemic Encephalopathy




