Top

Published in:

01-06-2020 | Magnetic Resonance Imaging | Original Article

Magnetic resonance imaging features of four neonates with total brain injury

Authors: Sachiko Koshino, Katsumi Hayakawa, Koichi Tanda, Hiroyuki Morishita, Kohji Ono, Akira Nishimura, Katsuhiro Koshino, Kei Yamada

Published in: Child's Nervous System | Issue 6/2020

Abstract

Purpose

The most severe form of profound asphyxia in neonates is now known as “total brain injury,” which forms part of the clinical spectrum of hypoxic-ischemic encephalopathy (HIE). Although the magnetic resonance (MR) imaging features of total brain injury remain to be determined, a widespread hyperintensity of the supratentorial brain, known as the “white cerebrum sign,” has been reported in diffusion-weighted images (DWI).

Methods

We examined four neonates who developed severe profound asphyxia.

Results

In the first week of life, all neonates showed the white cerebrum sign on DWI. A follow-up of these cases over a period of 1 month revealed diffuse bilateral multicystic encephalomalacia (MCE) as well as shrinkage of the basal ganglia and thalami (BG/T). These MR findings were common to all neonates, and all the neonates had severe adverse clinical outcomes.

Conclusion

Neonates, who exhibit the white cerebrum sign on MR imaging due to profound asphyxia, develop major disabilities, and MCE with shrinkage of the BG/T suggests miserable outcomes.

Miller SP, Ramaswamy V, Michelson D, Barkovich AJ, Holshouser B, Wycliffe N, Glidden DV, Deming D, Partridge JC, Wu YW, Ashwal S, Ferriero DM (2005) Patterns of brain injury in term neonatal encephalopathy. J Pediatr 146:453–460. https://doi.org/10.1016/j.jpeds.2004.12.026 CrossRefPubMed

Zimmerman RA, Bilaniuk LK (2006) Neuroimaging evaluation of cerebral palsy. Clin Perinatol 33:517–544. https://doi.org/10.1016/j.clp.2006.03.005 CrossRefPubMed

Ghei SK, Zan E, Nathan JE, Choudhri A, Tekes A, Huisman TA, Izbudak I (2014) MR imaging of hypoxic-ischemic injury in term neonates: pearls and pitfalls. Radiographics 34:1047–1061. https://doi.org/10.1148/rg.344130080 CrossRefPubMed

Vermeulen RJ, Fetter WP, Hendrikx L, Van Schie PE, van der Knaap MS, Barkhof F (2003) Diffusion-weighted MRI in severe neonatal hypoxic ischaemia: the white cerebrum. Neuropediatrics 34:72–76. https://doi.org/10.1055/s-2003-39599 CrossRefPubMed

Simon LV, Bragg BN APGAR score. Treasure Island (FL): Stat Pearls Publishing; 2018. http://www.ncbi.nlm.nih.gov/books/NBK470569. Accessed 15 June 2019

El-Gamasy MA, Alarabawy R (2018) Relation of serum creatinine to Sarnat scoring and brain computerized tomography of neonates with hypoxic ischemic encephalopathy. A single-center experience. J Pediatr Neurosci 13(4):437–442. https://doi.org/10.4103/JPN.JPN_64_18 CrossRefPubMedPubMedCentral

International Liaison Committee on Resuscitation (2005) International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 7: neonatal resuscitation. Resuscitation. 67(2–3):293–303. https://doi.org/10.1016/j.resuscitation.2005.09.014 CrossRef

Goergen SK, Ang H, Wong F, Carse EA, Charlton M, Evans R, Whiteley G, Clark J, Shipp D, Jolley D, Paul E, Cheong JL (2014) Early MRI in term infants with perinatal hypoxic-ischaemic brain injury: interobserver agreement and MRI predictors of outcome at 2 years. Clin Radiol 69(1):72–81. https://doi.org/10.1016/j.crad.2013.09.001 CrossRefPubMed

Palisano RJ, Cameron D, Rosenbaum PL, Walter SD, Russell D (2006) Stability of the gross motor function classification system. Dev Med Child Neurol 48(6):424–428. https://doi.org/10.1017/S0012162206000934 CrossRefPubMed

10.

Cabaj A, Bekiesińska-Figatowska M, Mądzik J (2012) MRI patterns of hypoxic-ischemic brain injury in preterm and full-term infants - classical and less common MR findings. Pol J Radiol 77(3):71–76CrossRef

11.

de Vries LS, Groenendaal F (2010) Patterns of neonatal hypoxic-ischaemic brain injury. Neuroradiol 52(6):555–566. https://doi.org/10.1007/s00234-010-0674-9 CrossRef

12.

Shankaran S, McDonald SA, Laptook AR, Hintz SR, Barnes PD, Das A, Pappas A, Higgins RD, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2015) Neonatal magnetic resonance imaging pattern of brain injury as a biomarker of childhood outcomes following a trial of hypothermia for neonatal hypoxic-ischemic encephalopathy. J Pediatr 167(5):987–993.e3. https://doi.org/10.1016/j.jpeds.2015.08.013 CrossRefPubMedPubMedCentral

13.

Barkovich AJ, Miller SP, Bartha A, Newton N, Hamrick SE, Mukherjee P, Glenn OA, Xu D, Partridge JC, Ferriero DM, Vigneron DB (2006) MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. AJNR Am J Neuroradiol 27(3):533–547PubMed

14.

Wolf A, Cowen D (1955) The cerebral atrophies and encephalomalacias of infancy and childhood. Res Publ Assoc Res Nerv Ment Dis 34:199–330PubMed

15.

Frigieri G, Guidi B, Costa Zaccarelli S, Rossi C, Muratori G, Ferrari F, Cavazzuti GB (1996) Multicystic encephalomalacia in term infants. Childs Nerv Syst 12:759–764CrossRef

16.

Krägeloh-Mann I (2004) Imaging of early brain injury and cortical plasticity. Exp Neurol 190:84–90. https://doi.org/10.1016/j.expneurol.2004.05.037 CrossRef

17.

Tekgul H, Serdaroglu G, Yalman O, Tutuncuoglu S (2004) Prognostic correlative values of the late-infancy MRI pattern in term infants with perinatal asphyxia. Pediatr Neurol 31:35–41. https://doi.org/10.1016/j.pediatrneurol.2003.11.012 CrossRefPubMed

18.

Garten L, Hueseman D, Stoltenburg-Didinger G, Felderhoff-Mueser U, Weizsaecker K, Scheer I, Boltshauser E, Obladen M (2007) Progressive multicystic encephalopathy: is there more than hypoxia-ischemia? J Child Neurol 22:645–649. https://doi.org/10.1177/0883073807302618 CrossRefPubMed

19.

Natsume J, Watanabe K, Kuno K, Hayakawa F, Hashizume Y (1995) Clinical, neurophysiologic, and neuropathological features of an infant with brain damage of total asphyxia type (Myers). Pediatr Neurol 13:61–64CrossRef

Title: Magnetic resonance imaging features of four neonates with total brain injury
Authors: Sachiko Koshino
Katsumi Hayakawa
Koichi Tanda
Hiroyuki Morishita
Kohji Ono
Akira Nishimura
Katsuhiro Koshino
Kei Yamada
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Child's Nervous System / Issue 6/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04457-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Magnetic resonance imaging features of four neonates with total brain injury

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2020

Cerebellar mutism after embolization of vermian arteriovenous malformation

Current concepts in the diagnosis and management of adolescent idiopathic scoliosis

In reply to: “Is it experience or lesson?”

Management and problems of prolonged survival with hydranencephaly in the modern treatment era

Upward vectors for osteogenic distraction treatment in secondary chronic intracranial hypertension in children undergoing scaphocephaly surgery: 2 cases reported

Spinal angiolipoma—a rare but reversible cause of paraplegia in a child