Hypoxic Ischemic Encephalopathy; Late Magnetic Resonance Imaging Findings Correlated with Clinical Findings, at Yehuleshet Specialty Clinic, December 2023, Addis Ababa, Ethiopia.
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Date
2023-12
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Addis Ababa University
Abstract
Introduction: Neonatal Hypoxic Ischemic Encephalopathy is a brain injury that occurswhen oxygen or blood flow to the brain is reduced or stopped before, during, or shortly afterbirth. Birth asphyxia is the main contributor to both long-term neurodevelopmental problems andinfant mortality in low- and middle-income nations. MRI examination can assist in elucidating the type of injury, the timing of injury, the pattern of pathological evolution, and changes inbrain metabolism over time.
Objectives: To explore the late Brain MRI patterns and associated clinical findings of childrenwho had clinical diagnosis of perinatal asphyxia in Addis Ababa, Ethiopia.
Methodology: The study is conducted in pediatric neurology clinic with MRI facility in Addis Ababa, Ethiopia. A total of 797 pediatric patient’s charts were identifiedwho had Brain MRI imaging evaluation. Of these, 70 cases with clinical diagnosis of perinatalasphyxia were included. Using a structured questioner, demographic data, pre and perinatalhistory of patients was collected. The MRI reports were reviewed by the principal investigator in a systematic pattern.
Result: The age at time of MRI evaluation ranges from 2 months to 14 years. Gestational age was assessed of which 74.3% are term and 25.7% are preterm. 42.9% of our patients received antenatal care (ANC) during gestation and 55.7% were delivered at a healthcare facility GlobalDevelopmental Delay (GDD), observed in 61.4% of the cases followed by Seizures occurring in21.4% of patients. 62.5% of preterm infants had periventricular leukomalacia on MRI as compared with those full-term (10.8%) infants, (P-value<0.001). And, (64.9%) of term infants had Subcortical/ deep watershed border zone hyperintensities on MRI as compared to with preterm (12.5%) infants. MRI findings suggestive of chronic injury, thinning of corpus callosum and cerebral cortical atrophy were seen 31.35 & 40% and 31.3% 37.3% respectively in preterm and term infants.
Conclusion: The study reveals high magnitude of perinatal asphyxia (8.8%) among pediatric Neurology clinic visits. Brain MRI imaging showed abnormality in majority of cases with specific dominant patterns seen being periventricular leukomalacia and subcortical/deep watershed hyperintensities for preterm and term infants respectively indicating that brain MRI should be used as primary diagnostic work up for these patients.
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MRI pattern Prenatal asphyxia Neonatal HIE Global Developmental Delay Addis Ababa Ethiopia