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Cowan F, Mercuri E, Groenendaal F, Bassi L, Ricci D, Rutherford M, de Vries LS (2005) Does cranial ultrasound imaging identify arterial cerebral infarction in term neonates? ... De Vries LS, Van der Grond J, Van Haastert IC, Groenendaal F (2005) Prediction of outcome in new-born infants with arterial ischaemic stroke using diffusion-weighted magnetic resonance imaging. ...doi:10.1007/s00234-010-0674-9 pmid:20390260 pmcid:PMC2872019 fatcat:wbyll43wwrce3akxtx54qhbj74
Perinatal brain injury at term is common and often manifests with neonatal encephalopathy including seizures. The most common aetiologies are hypoxic-ischaemic encephalopathy, intracranial haemorrhage and neonatal stroke. Besides clinical and biochemical assessment the diagnostic evaluation rely mostly on EEG and neuroimaging including cranial ultrasound and magnetic resonance imaging. The mechanisms underlying hypoxic-ischaemic brain injury are only partly understood but includedoi:10.1016/j.nbd.2015.09.011 pmid:26409031 pmcid:PMC4915441 fatcat:ithapeuojbbcjduc3amvdyps6a
more »... mitochondrial perturbation, necrosis/apoptosis and inflammation. Neuroprotective treatment of newborns suffering from hypoxic-ischaemic encephalopathy with hypothermia has proven effective and has been introduced as a clinical routine. Ongoing studies are exploring various add-on therapies including erythropoietin, xenon, topiramate, melatonin and stem cells.
BMJ Paediatrics Open
ReFeRenCes 2 Groenendaal F. BMJ Paediatrics Open 2019;3:e000494. doi:10.1136/bmjpo-2019-000494 on 26 June 2019 by guest. ...doi:10.1136/bmjpo-2019-000494 pmid:31206085 pmcid:PMC6542417 fatcat:j3kbyme6ireytd4q7w223gdy6a
Neonates are known to have a higher risk of cerebral sinovenous thrombosis than children of other age groups. The exact incidence in neonates remains unknown and is likely to be underestimated, as clinical presentation is nonspecific and diagnosis can only be made when dedicated neuroimaging techniques, including computed tomographic venography or magnetic resonance venography, are performed. Associated intracranial lesions are common and some, such as a unilateral thalamic hemorrhage, shoulddoi:10.1177/0883073811408090 pmid:21693652 pmcid:PMC3674555 fatcat:lluyva2eyrhhxh36hb2375kq4u
more »... ggest cerebral sinovenous thrombosis as the underlying etiology. Neurodevelopmental outcome is poor in about 50% of these infants and is adversely affected by associated parenchymal lesions. Anticoagulation therapy will limit propagation of the clot and possibly the development or enhancement of parenchymal lesions. Multicenter randomized clinical trials are urgently needed to address many of these important issues.
An adverse outcome is still encountered in 45% of full-term neonates with perinatal asphyxia who are treated with moderate hypothermia. At present pharmacologic therapies are developed to be added to hypothermia. In the present article, these potential neuroprotective interventions are described based on the molecular pathways set in motion during fetal hypoxia and following reoxygenation and reperfusion after birth. These pathways include excessive production of excitotoxins with subsequentdoi:10.1053/j.semperi.2015.12.003 pmid:26794492 fatcat:ucp6xt452jg65cwfll2qa6pw4e
more »... r-stimulation of NMDA receptors and calcium influx in neuronal cells, excessive production of reactive oxygen and nitrogen species, activation of inflammation leading to inappropriate apoptosis, and loss of neurotrophic factors. Possibilities for pharmacologic combination therapy, where each drug will be administered based on the optimal point of time in the cascade of destructive molecular reactions, may further reduce brain damage due to perinatal asphyxia.
Perinatal hypoxia-ischemia (HI) is an important cause of neonatal brain injury. Recent progress in the search for neuroprotective compounds has provided us with several promising drugs to reduce perinatal HI-induced brain injury. In the early stage (first 6 hours after birth) therapies are concentrated on prevention of the production of reactive oxygen species or free radicals (xanthine-oxidase-, nitric oxide synthase-, and prostaglandin inhibition), anti-inflammatory effects (erythropoietin,doi:10.2174/157015910793358150 pmid:21629441 pmcid:PMC3080590 fatcat:44akizfaojhkbigqqg6l3wlboi
more »... latonin, Xenon) and anti-apoptotic interventions (nuclear factor kappa B-and c-jun N-terminal kinase inhibition); in a later stage stimulation of neurotrophic properties in the neonatal brain (erythropoietin, growth factors) can be targeted to promote neuronal and oligodendrocyte regeneration. Combination of pharmacological means of treatment with moderate hypothermia, which is accepted now as a meaningful therapy, is probably the next step in clinical treatment to fight post-asphyxial brain damage. Further studies should be directed at a more rational use of therapies by determining the optimal time and dose to inhibit the different potentially destructive molecular pathways or to enhance endogenous repair while at the same time avoiding adverse effects of the drugs used.
Hypoxic-ischemic encephalopathy (HIE) is a major cause of neurological sequelae in (near-)term newborns. Despite the use of therapeutic hypothermia, a significant number of newborns still experience impaired neurodevelopment. Neuroimaging is the standard of care in infants with HIE to determine the timing and nature of the injury, guide further treatment decisions, and predict neurodevelopmental outcomes. Cranial ultrasonography is a helpful noninvasive tool to assess the brain beforedoi:10.3390/diagnostics12030645 pmid:35328199 pmcid:PMC8947468 fatcat:e36sdnpbu5cgtga2p2sjcmn6pm
more »... of hypothermia to look for abnormalities suggestive of HIE mimics or antenatal onset of injury. Magnetic resonance imaging (MRI) which includes diffusion-weighted imaging has, however, become the gold standard to assess brain injury in infants with HIE, and has an excellent prognostic utility. Magnetic resonance spectroscopy provides complementary metabolic information and has also been shown to be a reliable prognostic biomarker. Advanced imaging modalities, including diffusion tensor imaging and arterial spin labeling, are increasingly being used to gain further information about the etiology and prognosis of brain injury. Over the past decades, tremendous progress has been made in the field of neonatal neuroimaging. In this review, the main brain injury patterns of infants with HIE, the application of conventional and advanced MRI techniques in these newborns, and HIE mimics, will be described.
Occurrence of cPVL has been demonstrated after severe hypocapnia and subsequent cerebral vasoconstriction (Groenendaal and de Vries, 2001) . ... Copyright © 2019 van Bel, Vaes and Groenendaal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). ...doi:10.3389/fphys.2019.00181 pmid:30949060 pmcid:PMC6435588 fatcat:euen3ttcvzb6zoagrxxafk5lnu
Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. de Sévaux/Nikkels/Lequin/Groenendaal Neonatology 2019;115:89-93 90 DOI: 10.1159 ... Table 3 . 3 Number of additional findings (class I-IV), according to Goldman et al.  , per type of condition Neonatology 2019;115:89-93 DOI: 10.1159/000493003 7 de Sévaux/Nikkels/Lequin/Groenendaal ...doi:10.1159/000493003 pmid:30352441 pmcid:PMC6425852 fatcat:lasmeipupnbcnggkviptdf67d4
Footnote Conflicts of Interest: Herewith the authors of this manuscript, Frank van Bel, MD and Floris Groenendaal, MD declare that Frank van Bel and Floris Groenendaal are, together with Cacha Peeters-Scholte ...doi:10.21037/pm.2019.11.02 fatcat:5o3fkp4pxnhyxehlpautbr6w5e
Care was redirected. van Weissenbruch/Groenendaal/de Vries infants, while ischaemic lesions were found in the other 3 infants. Neonatology 2016;109:282-288 DOI: 10.1159/000443320 286 ure 1 . ...doi:10.1159/000443320 pmid:26886231 fatcat:6of64sjgfjbevpxl2y4crgsek4
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