Patterns of damage in the mature neonatal brain

Fabio Triulzi, Cecilia Parazzini, Andrea Righini

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography.

Original languageEnglish
Pages (from-to)608-620
Number of pages13
JournalPediatric Radiology
Volume36
Issue number7
DOIs
Publication statusPublished - Jul 2006

Fingerprint

Brain Hypoxia-Ischemia
Infarction
Brain
Metabolic Diseases
Brain Edema
Wounds and Injuries
Kernicterus
Pyramidal Tracts
Rare Diseases
Hypoglycemia
Hematoma
Brain Injuries
Angiography
Hemorrhage
Morbidity
Infection

Keywords

  • Brain
  • Diffusion imaging
  • Hypoxic-ischaemic encephalopathy
  • MRI
  • Newborn

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology

Cite this

Patterns of damage in the mature neonatal brain. / Triulzi, Fabio; Parazzini, Cecilia; Righini, Andrea.

In: Pediatric Radiology, Vol. 36, No. 7, 07.2006, p. 608-620.

Research output: Contribution to journalArticle

Triulzi, Fabio ; Parazzini, Cecilia ; Righini, Andrea. / Patterns of damage in the mature neonatal brain. In: Pediatric Radiology. 2006 ; Vol. 36, No. 7. pp. 608-620.
@article{5af0a9c4cbab4375bab05f5258ae1843,
title = "Patterns of damage in the mature neonatal brain",
abstract = "Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography.",
keywords = "Brain, Diffusion imaging, Hypoxic-ischaemic encephalopathy, MRI, Newborn",
author = "Fabio Triulzi and Cecilia Parazzini and Andrea Righini",
year = "2006",
month = "7",
doi = "10.1007/s00247-006-0203-5",
language = "English",
volume = "36",
pages = "608--620",
journal = "Pediatric Radiology",
issn = "0301-0449",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - Patterns of damage in the mature neonatal brain

AU - Triulzi, Fabio

AU - Parazzini, Cecilia

AU - Righini, Andrea

PY - 2006/7

Y1 - 2006/7

N2 - Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography.

AB - Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography.

KW - Brain

KW - Diffusion imaging

KW - Hypoxic-ischaemic encephalopathy

KW - MRI

KW - Newborn

UR - http://www.scopus.com/inward/record.url?scp=33745098637&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745098637&partnerID=8YFLogxK

U2 - 10.1007/s00247-006-0203-5

DO - 10.1007/s00247-006-0203-5

M3 - Article

C2 - 16770665

AN - SCOPUS:33745098637

VL - 36

SP - 608

EP - 620

JO - Pediatric Radiology

JF - Pediatric Radiology

SN - 0301-0449

IS - 7

ER -