Mercuri E, Guzzetta A, Haataja L, Cowan F, Rutherford M, Counsell S, Papadimitriou M, Cioni G, Dubowitz L
Department of Paediatrics, Imperial College, London, UK.
Neuropediatrics. 1999 Apr;30(2):83-9. doi: 10.1055/s-2007-973465.
Neurological examination and magnetic resonance imaging were performed in the neonatal period in 58 full-term infants who presented with hypoxic-ischaemic encephalopathy. The aim of this study was to evaluate the patterns of neurological abnormalities and their correlation to brain lesions on MRI. The prognostic value of the neurological examination performed at different times in the neonatal period was also evaluated. Our results showed that specific clinical patterns can be observed in infants with HIE and these can be related to the pattern of lesion on brain MRI. In particular, while infants with normal MRI or minimal changes tend to show only minor tone abnormalities after the first week of life, infants with more severe lesions such as basal ganglia lesions show persistent and diffuse neurological abnormalities. Infants with white matter changes but intact basal ganglia show a different clinical pattern with improved sucking reflex and behaviour and less severe tone abnormalities. Our results also suggested that the neurological examination performed after the second week of life is a reliable indicator of outcome in these infants.
对58例足月新生儿缺氧缺血性脑病患儿在新生儿期进行了神经学检查和磁共振成像。本研究的目的是评估神经学异常模式及其与MRI脑损伤的相关性。还评估了在新生儿期不同时间进行的神经学检查的预后价值。我们的结果表明，HIE患儿可观察到特定的临床模式，这些模式可能与脑MRI上的损伤模式有关。特别是，MRI正常或变化轻微的婴儿在出生后第一周后往往仅表现出轻微的肌张力异常，而有更严重损伤（如基底节损伤）的婴儿则表现出持续和弥漫性的神经学异常。白质改变但基底节完整的婴儿表现出不同的临床模式，吸吮反射和行为改善，肌张力异常较轻。我们的结果还表明，出生后第二周后进行的神经学检查是这些婴儿预后的可靠指标。
