Symmetrical bithalamic hyperdensities in asphyxiated full-term newborns: An early indicator of status marmoratus (original) (raw)
Related papers
MRI Changes in the Thalamus and Basal Ganglia of Full-Term Neonates with Perinatal Asphyxia
Neonatology, 2018
Magnetic resonance imaging (MRI) is the standard neuroimaging technique to assess perinatal asphyxia-associated brain injury in full-term infants. Diffusion-weighted imaging (DWI) is most informative when assessed during the first week after the insult. To study the DWI abnormalities of the thalamus and basal ganglia in full-term infants with perinatal asphyxia. Fifty-five (near) term infants (normothermia n = 23; hypothermia n = 32) with thalamus and/or basal ganglia injury were included. MRI findings were assessed visually and quantitatively calculating apparent diffusion coefficient (ADC) values. Thalamus/basal ganglia ADC ratios were calculated to analyze the differences between these areas. Infants with an early MRI (days 1-3) or later MRI (days 4-7) were compared. Isolated extensive thalamic injury was seen early, and focal thalamic and basal ganglia injury was seen later. On the early MRI, visual assessment underestimated abnormalities in the basal ganglia (59% abnormal vs. 9...
Pediatric Neurology, 1995
An infant who demonstrated clinical features compatible with total asphyxia is reported. Immediately after birth, the patient manifested severe hypotonia and total absence of cranial nerve functions. Magnetic resonance imaging revealed abnormal intensity of the thalamns and putamen, and atrophy of the bralnstem. Late components of brainstem auditory evoked potential were absent, but electroencephalography was normal. Postmortem autopsy revealed destructive lesions of the brainstem tegmentum, thalamus, basal ganglia, and spinal cord, but preserved cerebral cortex; fmdings consistent with those of total asphyxia as reported by Myers, and attributable to prenatal insult. Natsume J, Watanabe K, Kuno K, Hayakawa F, Hashizume Y. Clinical, neurophysiologic, and neuropathological features of an infant with brain damage of total asphyxia type (Myers). Pediatr Neurol 1995;13:61-64.
Innovative Publication, 2017
Objectives: The aim of the study was to estimate the proportion of MRI changes in newborns with HIE, to compare the findings of term and preterm babies and to identify if there is any clinical stage specific MRI findings Methods: After obtaining clearance from ethical committee, 30 newborns with either stage II or stage III HIE are included in the study. MRI brain was taken between one to two weeks of age once the vitals of the babies are stable & after ensuring euthermia. Results: Out of the 30 babies, 19 were male babies and 11 female babies. 16 of them were term and 14 of them preterm babies.27 of the total 30 patients had MRI changes of HIE, which accounts for 90%. 17of the 30 mothers were primi mothers which accounts for 56.7%. Most important antenatal factors associated with HIE are gestational hypertension and UTI. Gestational diabetes mellitus and placental/cord factors are also found to be important contributing factors. 33.4% had a history of UTI, 30% gestational hypertension, 23.4% gestational diabetes mellitus in the antenatal period. Conclusion: Basal ganglia and/or thalamus were affected in 50% of term babies. 87.5% of babies with periventricular leucomalacia are preterms. Intracranial hemorrhage was seen in 7.4% of the babies and all of them were preterms. Out of the four babies with clinical stage III HIE, 50% of them had bilateral basal ganglia involvement. 25% had thalamic involvement. In stage II HIE, no specific change could be found.
Serial 1- and 2-Dimensional Cerebral MRI Measurements in Full-Term Infants after Perinatal Asphyxia
Neonatology, 2016
Cranial magnetic resonance imaging (MRI) is associated with neurodevelopmental outcome in full-term infants with neonatal encephalopathy (NE) following presumed perinatal asphyxia. The aim of this study is to relate 2-dimensional measurements of the basal ganglia and thalami (BGT) and cerebellum in the first week after birth and after 3 months with neurodevelopmental outcome at 18 months. Retrospectively, 29 full-term infants with NE following presumed perinatal asphyxia who had a cranial MRI in the first week after birth were studied serially. One- and 2-dimensional measurements were obtained and related to different patterns of brain injury, and neurodevelopmental outcome at 18 months. A Griffiths developmental quotient <85 or cerebral palsy was considered adverse. On the first MRI, the adverse outcome group showed increased basal ganglia width (42.1 ± 0.1 vs. 40.3 ± 0.3 mm, p < 0.001), thalamic width (40.3 ± 0.1 vs. 39.3 ± 1.0 mm, p < 0.001), and basal ganglia surface (1...
Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants
Journal of Perinatology, 2006
To determine the incidence and factors associated with diffuse basal ganglia or thalamus hyperechogenicity (BGTH) in preterm infants. (1) Review of serial neurosonograms among neonates with gestational age (GA) <34 weeks born at Weiler Hospital during a 21-month period; (2) Color Doppler flow imaging; (3) Case-control study using GA group-matched controls; and (4) Blind reading of CT scans or MRIs in patients with BGTH. Among 289 infants, 24 (8.3%) had diffuse BGTH. Color Doppler flow imaging was normal in nine patients. The incidence of diffuse BGTH was inversely related to GA (P<0.01). Logistic regression (n=96) showed that diffuse BGTH was significantly associated with requirement of high-frequency oscillation (HFO) (P=0.031), severe intraventricular hemorrhage (IVH) (P=0.004), hypotension requiring vasopressors (P=0.040), hypoglycemia (P=0.031) and male gender (P=0.014). Most patients with diffuse BGTH had normal basal ganglia and thalamus on CT/MRI, one had a hemorrhage, and one had an ischemic infarction. In our series, diffuse BGTH occurred in 8.3%, and was associated with factors similar to those previously reported. In contrast, several series have reported almost exclusively linear or punctuate hyperechoic foci, corresponding to hyperechogenicity of the lenticulostriate vessels. Our data provide further evidence to suggest that diffuse BGTH and hyperechogenicity of the lenticulostriate vessels are two different entities. Additional studies are required to determine the long-term significance of diffuse BGTH.
Transient Hypermetabolism of the Basal Ganglia Following Perinatal Hypoxia
Pediatric Neurology, 2007
Positron emission tomography can be used to evaluate brain function following perinatal hypoxia. This case report demonstrates transient hypermetabolism in the basal ganglia detected by glucose metabolism positron emission tomography study in a newborn who suffered hypoxic-ischemic encephalopathy and developed dystonic cerebral palsy later. A scan repeated at 4 years of age showed severe hypometabolism in the lentiform nuclei and thalami. Transient hypermetabolism in the basal ganglia following perinatal hypoxia may be related to excitotoxic damage causing permanent neurological symptoms in the form of dystonic cerebral palsy. Thus, positron emission tomography can help predict this form of cerebral palsy in neonates.