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Determining the Extent of Brain Damage in Children with HIE

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If you are the parent of a child with hypoxic ischemic encephalopathy (HIE), you may be wondering how doctors can determine the severity of your child’s birth injury and its potential impact long-term. Recent research has shown the efficacy of using magnetic resonance imaging (MRI) to predict outcomes in children who suffer from HIE.

Predicting Long Term Outcomes in Children with Hypoxic Ischemic Encephalopathy

HIE is a brain injury that occurs when a baby suffers birth asphyxia. Birth asphyxia is defined as a lack of oxygen during the time surrounding birth. When a child’s brain doesn’t receive enough oxygen, brain cells begin to die, causing permanent brain damage. While the causation of hypoxic ischemic encephalopathy is generally attributed to oxygen deprivation, the extent of the resulting brain damage is highly variable.

HIE can cause a broad range of conditions and complications, including cognitive impairments, developmental delays, and motor disabilities. The disabilities that affect a specific child can range from mild to severe depending on the location of the brain where the damage occurred, the timing of the brain injury, and the extent of the brain damage in an individual case.

MRI Scoring System for HIE Brain Damage Sufferers

Predicting short and long-term outcomes in infants who have hypoxic-ischemic encephalopathy (HIE) can be very challenging. Researchers and those in the medical field are constantly searching for new ways to evaluate the extent and affect of a child’s brain damage. Recently, one investigation made significant inroads in this area.

A study published in the medical journal Pediatric Neurology illustrates the utility of a new scoring system based on MRI to assess the extent of brain damage in individual cases of hypoxic ischemic encephalopathy (HIE). Researchers at the Washington University School of Medicine developed this new clinical MRI scoring system to examine the infant brain with HIE and predict neurological and developmental outcomes at 18 to 24 months.

While there are established methodologies often used to assess the newborn brain after oxygen deprivation during birth, this new system concentrates on one component of the brain called deep nuclear gray matter. Injuries to the deep nuclear gray matter in babies with hypoxic-ischemic encephalopathy (HIE) are associated with worse neurodevelopmental outcomes.

The study conducted MRI scans on 57 infants with moderate to severe HIE who had already received therapeutic hypothermia treatment. Each baby underwent at least 1 brain scan during the first 2 weeks of life. The majority of infants underwent one MRI between 2 and 6 days old and then another MRI between 8 and 12 days old. These brain scans were then evaluated using the newly developed HIE scoring system. The infants were assessed again at 18-24 months using the Bayley Scales of Infant and Toddler Development-III (Bayley-III), which focuses on cognitive, motor and language abilities.

In 95% of infants, higher grades on the MRI injury scale were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. Essentially, this means that the scoring system was effective at predicting the degree of challenges associated with a newborn’s HIE brain injury.

Why Effective HIE Evaluation Matters

Overall, this scoring system can assist doctors in more accurately determining the prognosis for children with HIE in the near and long-term. This can also help parents to adjust expectations and provide better support for their children as they seek to improve quality of life. Moreover, it can help a multi-discliplinary team of healthcare providers to develop the best collaborative approach to a specific child’s care. Ultimately, it serves as a highly valuable tool for medical professionals seeking to help children with hypoxic ischemic encephalopathy and their caregivers with early intervention treatments and therapies that support better outcomes.

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