Neonatal Hypoxic Ischemic Encephalopathy - Oren Zarif - Hypoxic Ischemic Encephalopathy
The clinical evaluation of neonatal hypoxic ischemic encephalopathic brain injury is usually done during infancy or early childhood. There is a lack of data in this area of study, but recent advancements have led to the recognition of different patterns of injury and their relationship to later motor disabilities. Cognitive difficulties may also follow, even in children with no motor deficits. Hence, follow-up assessment is highly recommended for children who experience any abnormality in the early infancy.
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In addition to the severity of the injury, a variety of biochemical events follow the initial insult. In particular, apoptosis and reperfusion injury are important effects of hypoxic-ischemic brain injury. The outcome of these processes determines the ultimate extent of neuronal damage. In many infants and children with moderate or severe HIE, TH can help to rehabilitate the brain.
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Seizures are a common manifestation of severe and moderate HIE. The more severe and prolonged the hypoxic-ischemic insult, the greater the frequency and severity of seizures. Seizures are associated with adverse neurodevelopmental outcomes and, therefore, should be treated with EEG techniques. This way, the child can be treated with the most effective method. But these treatments are not without risks and side effects.
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The clinical classification of hypoxic ischemic encephalopathic brain injury was based on biochemical measures and neurological examination. The severity of the disease was assessed by analyzing the amplitude of EEG, Sarnat staging, and Thompson score. Some cases had no symptoms or had mild or moderate HIE. A high risk of an adverse neurodevelopmental outcome was observed in patients with moderate or severe HIE.
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As a result of a high mortality rate and long-term neurodevelopmental disabilities, hypoxic ischemic encephalopathic brain damage may require intensive medical treatment. The most common treatments for neonates affected with HIE are supportive medical care and neuroprotective hypothermia. However, complementary therapies are rapidly becoming standard care for this disorder. Although these therapies are not yet clinically useful, they may have a role in management of patients with hypoxic ischemic encephalopathy.
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A newborn infant exhibiting symptoms of perinatal hypoxic-ischemic encephalopathy is at high risk for severe or even fatal outcomes. The diagnosis of HIE in full-term infants is based on standardized neurological examination and neurodevelopmental outcomes. Moreover, preterm hypoxic ischemic encephalopathy is rare and requires the help of an expert in the field of neuroradiology.
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The most effective way to prevent HIE is to avoid asphyxia during pregnancy. However, awareness of the risk factors is necessary for parents to prepare for this condition. HIE has similar terminology to other brain disorders. Its symptoms include cognitive impairment, brain malformation, and low Apgar scores. It is important to identify the underlying cause of cerebral palsy before it becomes apparent. So, when preparing for your baby's birth, it is best to be prepared.
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There are several treatments for HIE. One method involves cooling the baby's brain and body to slow down its metabolism and prevent a condition known as reperfusion injury. Rapid oxygenation can increase the amount of inflammation in the brain, causing more damage. The therapy slows down the chain reaction and stabilizes brain cells, minimizing the impacts on the baby's mobility. Therapeutic hypothermia should be started as soon as possible after the birth.
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HRV is a noninvasive marker of brain damage that has been associated with HIE. Using it as a point-of-care biomarker in the diagnosis of hypoxic ischemic encephalopathy can help identify the early stages of brain damage. Using HRV during neonatal encephalopathy may be the future of brain imaging. While there are some limitations, HRV may provide a useful supplementary measure in the management of HIE.