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Arch Dis Child Fetal Neonatal Ed. 1996 Nov; 75(3): F145–F151.
PMCID: PMC1061190

Hypoxic-ischaemic encephalopathy: early and late magnetic resonance imaging findings in relation to outcome.


Sixteen infants with hypoxic-ischaemic encephalopathy (HIE) were studied using serial magnetic resonance imaging (MRI) up to the age of 2 years. The infants had regular neurological and developmental assessments. An nuclear magnetic resonance (NMR) score was devised to quantify the early and late MRI findings and a neurological optimality score was used to quantify abnormal neurological signs at the time of the final examination. The follow up MRI score was compared with the neonatal MRI score and the outcome of the child. There was a strong positive correlation between the neonatal and follow up MRI scores and between MRI scores and optimality score. All infants with a normal outcome had patchy white matter abnormalities. All infants with an abnormal outcome had extensive white matter abnormalities. The outcome was most severe in those infants with additional basal ganglia atrophy with or without cyst formation. Infants with mild HIE who are developmentally normal at the age of 2 years do not have normal MRI scans and may be at risk of minor neurological problems by school age. Bilateral basal ganglia abnormalities are associated with severe developmental delay, but infants with mainly white matter and cortical abnormalities have less severe problems despite extensive tissue loss.

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  • McArdle CB, Richardson CJ, Hayden CK, Nicholas DA, Amparo EG. Abnormalities of the neonatal brain: MR imaging. Part II. Hypoxic-ischemic brain injury. Radiology. 1987 May;163(2):395–403. [PubMed]
  • Barkovich AJ, Truwit CL. Brain damage from perinatal asphyxia: correlation of MR findings with gestational age. AJNR Am J Neuroradiol. 1990 Nov-Dec;11(6):1087–1096. [PubMed]
  • Byrne P, Welch R, Johnson MA, Darrah J, Piper M. Serial magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy. J Pediatr. 1990 Nov;117(5):694–700. [PubMed]
  • Keeney SE, Adcock EW, McArdle CB. Prospective observations of 100 high-risk neonates by high-field (1.5 Tesla) magnetic resonance imaging of the central nervous system. II. Lesions associated with hypoxic-ischemic encephalopathy. Pediatrics. 1991 Apr;87(4):431–438. [PubMed]
  • Baenziger O, Martin E, Steinlin M, Good M, Largo R, Burger R, Fanconi S, Duc G, Buchli R, Rumpel H, et al. Early pattern recognition in severe perinatal asphyxia: a prospective MRI study. Neuroradiology. 1993;35(6):437–442. [PubMed]
  • Kuenzle C, Baenziger O, Martin E, Thun-Hohenstein L, Steinlin M, Good M, Fanconi S, Boltshauser E, Largo RH. Prognostic value of early MR imaging in term infants with severe perinatal asphyxia. Neuropediatrics. 1994 Aug;25(4):191–200. [PubMed]
  • Rutherford MA, Pennock JM, Dubowitz LM. Cranial ultrasound and magnetic resonance imaging in hypoxic-ischaemic encephalopathy: a comparison with outcome. Dev Med Child Neurol. 1994 Sep;36(9):813–825. [PubMed]
  • Martin E, Barkovich AJ. Magnetic resonance imaging in perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed. 1995 Jan;72(1):F62–F70. [PMC free article] [PubMed]
  • Rutherford MA, Pennock JM, Schwieso JE, Cowan FM, Dubowitz LM. Hypoxic ischaemic encephalopathy: early magnetic resonance imaging findings and their evolution. Neuropediatrics. 1995 Aug;26(4):183–191. [PubMed]
  • Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976 Oct;33(10):696–705. [PubMed]
  • Hajnal JV, De Coene B, Lewis PD, Baudouin CJ, Cowan FM, Pennock JM, Young IR, Bydder GM. High signal regions in normal white matter shown by heavily T2-weighted CSF nulled IR sequences. J Comput Assist Tomogr. 1992 Jul-Aug;16(4):506–513. [PubMed]
  • Ball WS., Jr Magnetic resonance imaging of the infant brain. Semin Ultrasound CT MR. 1991 Oct;12(5):379–409. [PubMed]
  • Barkovich AJ. MR and CT evaluation of profound neonatal and infantile asphyxia. AJNR Am J Neuroradiol. 1992 May-Jun;13(3):959–975. [PubMed]
  • Truwit CL, Barkovich AJ, Koch TK, Ferriero DM. Cerebral palsy: MR findings in 40 patients. AJNR Am J Neuroradiol. 1992 Jan-Feb;13(1):67–78. [PubMed]
  • Roland EH, Hill A, Norman MG, Flodmark O, MacNab AJ. Selective brainstem injury in an asphyxiated newborn. Ann Neurol. 1988 Jan;23(1):89–92. [PubMed]
  • Myers RE. Two patterns of perinatal brain damage and their conditions of occurrence. Am J Obstet Gynecol. 1972 Jan 15;112(2):246–276. [PubMed]
  • Rutherford MA, Pennock JM, Murdoch-Eaton DM, Cowan FM, Dubowitz LM. Athetoid cerebral palsy with cysts in the putamen after hypoxic-ischaemic encephalopathy. Arch Dis Child. 1992 Jul;67(7 Spec No):846–850. [PMC free article] [PubMed]
  • Yokochi K, Aiba K, Kodama M, Fujimoto S. Magnetic resonance imaging in athetotic cerebral palsied children. Acta Paediatr Scand. 1991 Aug-Sep;80(8-9):818–823. [PubMed]
  • Eken P, Jansen GH, Groenendaal F, Rademaker KJ, de Vries LS. Intracranial lesions in the fullterm infant with hypoxic ischaemic encephalopathy: ultrasound and autopsy correlation. Neuropediatrics. 1994 Dec;25(6):301–307. [PubMed]
  • van der Knaap MS, Smit LS, Nauta JJ, Lafeber HN, Valk J. Cortical laminar abnormalities--occurrence and clinical significance. Neuropediatrics. 1993 Jun;24(3):143–148. [PubMed]
  • Dambska M, Dydyk L, Szretter T, Wozniewicz J, Myers RE. Topography of lesions in newborn and infant brains following cardiac arrest and resuscitation. Damage to brain and hemispheres. Biol Neonate. 1976;29(3-4):194–206. [PubMed]
  • Pasternak JF, Predey TA, Mikhael MA. Neonatal asphyxia: vulnerability of basal ganglia, thalamus, and brainstem. Pediatr Neurol. 1991 Mar-Apr;7(2):147–149. [PubMed]
  • Hajnal JV, Saeed N, Oatridge A, Williams EJ, Young IR, Bydder GM. Detection of subtle brain changes using subvoxel registration and subtraction of serial MR images. J Comput Assist Tomogr. 1995 Sep-Oct;19(5):677–691. [PubMed]

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