Hypoxic Ischemic Encephalopathy - Oren Zarif - Hypoxic Ischemic Encephalopathy

While there are many causes of hypoxic ischemic encephalopathies, one of the most common is birth asphyxia. Its underlying cause is not yet known definitively. Many factors may contribute to the infant's asphyxia, including prematurity and low birth weight. Nonetheless, the resulting brain injury is serious. Some estimates suggest that up to twenty percent of asphyxiated newborns die during their newborn period, with an additional 25 percent developing neurological sequelae. These neurological insults pose significant short and long-term costs to the family.

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The duration of hypoxic-ischemic brain injury affects how quickly neurons recover. The final degree of neuronal damage depends on the severity of the initial insult, the extent of reperfusion injury, and the extent of apoptosis, which is a natural response to brain injury. Many biochemical events follow a hypoxic-ischemic insult. As a result, there are different types of HIE.

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In addition to reduced cerebral perfusion, reduced oxygen delivery to the brain causes a mismatch between oxidative metabolism and cerebral blood flow. Hypoxic ischemic encephalopathy can cause neonatal death, as well as a host of neurodevelopmental defects. Studies have shown that approximately 25-30% of infants with HIE will have permanent neurodevelopmental disabilities. However, the specific mechanisms responsible for this damage are not yet known.

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Seizures are a common complication of moderate and severe HIE. In addition to being an early symptom of the disorder, seizures may also result from prolonged hypoxia-ischemia. Seizures are particularly common among asphyxiated infants, and the more severe the condition, the more likely it is to result in a neurological disability. A series of studies have found that repetitive seizures can have detrimental effects on the developing brain. As a result, effective seizure management is critical.

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In general, preventing asphyxia is the best way to avoid HIE. However, parents should be aware of hypoxic ischemic encephalopathy risk factors. Being aware of the causes, symptoms, and risks is the best way to prepare for this situation. This disease can lead to permanent disability if not treated properly. For parents, the most important thing is to be aware of the symptoms and avoid the situation.

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Neuroprotective measures can improve outcomes in infants who have mild HIE. For example, therapeutic hypothermia has been found to reduce neurologic death and morbidity after HIE. Many major academic centers have instituted this therapy as a standard of care for hypoxic ischemic encephalopathy. Additionally, ongoing studies are testing the effectiveness of continuous electroencephalography monitoring and therapeutic hypothermia to decrease symptoms and protect brain tissue.

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While there is no clear evidence that hypoxic ischemic encephalopathic brain injury can occur during prenatal or postnatal life, there are some basic patterns of this condition. Infants who have suffered perinatal asphyxia experience pontosubicular neuronal injury and a cerebellar lesion. A dominant lesion may involve the cerebral white matter. In about 15% of cases, the lesion may involve the cerebellar white matter.

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Angiogenesis is a crucial component of hypoxic ischemic encephalopathic brain injury, which requires extensive signaling networks to be effective. Important components of this process include the vascular endothelial growth factor protein VEGF. Other components of this complex include angiopoietin-1 and hypoxia-inducing factor-1 alpha. Epo has anti-inflammatory properties and promotes neurogenesis, oligodendrogenesis, and angiogenesis.

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When the symptoms of hypoxic ischemic encephalopathic brain damage become apparent, medical providers must act quickly. Therapeutic hypothermia, also known as cooling the body, helps slow down the cellular degeneration and brain damage process. Treatment options for HIE include therapy and medication. If the condition is diagnosed early enough, the risk of future complications is minimized. The treatment process may not be entirely successful, but can help the baby survive.