The Evolution and Consequences of Perinatal Ischemic Brain Injury
Hypoxic-ischemic encephalopathy (HIE) is the most common form of neonatal brain injury, contributing to 25% of newborn deaths worldwide with many survivors suffering from adverse outcomes including cerebral palsy, epilepsy and intellectual disability. While therapeutic hypothermia is established as standard-of-care for infants with HIE, it is only partially effective with nearly half of treated survivors still suffering from later neurological disabilities. Neonatal magnetic resonance imaging (MRI) has assisted in defining the patterns of acute brain injury with imaging focusing on the first 2 weeks after birth. However, as the injury appears to evolve over many weeks, serial systematic neuroimaging with MRI is needed to define the evolution of the primary injury to inform adjuvant neuroprotective therapies. In addition, there is a lack of studies defining the impact of this injury on subsequent brain development. Such data would inform the timing for neuro-rehabilitative interventions. Thus, we aim to utilize serial MRI from birth to 6 months to define the evolution of brain injury and its impact on structural and functional development, and its relation to 1-year neurodevelopmental outcome.
