Low cerebral blood flow velocity and head circumference in infants with severe hypoxic ischemic encephalopathy and poor outcome

Acta Paediatr. 2009 Mar;98(3):459-65. doi: 10.1111/j.1651-2227.2008.01119.x. Epub 2008 Nov 11.

Abstract

Aims: To evaluate long-term changes in cerebral blood flow velocity (CBFV) and head circumference in asphyxiated infants.

Methods: CBFV was measured in 83 asphyxiated and 115 healthy term infants in anterior and middle cerebral, basilar and internal carotid artery (ICA) up to the age of 60-149 days. The psychomotor development and head circumference was followed for 18 months. RESULTS. Mean CBFV was increased (p < 0.05) during the first days after asphyxia in infants with severe hypoxic-ischemic encephalopathy (HIE) (n = 25) compared to control group or infants with mild to moderate HIE (n = 58) with maximum values found at the age of 36-71.9 h: in ICA (mean [95% CI]) 31.2 (25.5-36.6) cm/s in severe HIE infants compared to 13.0 (12.2-13.9) cm/s in controls. Decreased (p < 0.0001) mean CBFV developed in severe HIE infants by the age of 21-59 days: in ICA 14.1 (11.5-16.8) cm/s compared to 22.9 (21.4-24.4) cm/s in controls. Infants with severe HIE had similar mean height but lower head circumferences compared to controls (p < 0.05) at the age of 21-59 days.

Conclusion: The high mean CBFV found in infants with severe HIE during the first days after asphyxia is temporary and low CBFV and head circumference develops by the age of 21-59 days.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asphyxia Neonatorum / diagnostic imaging*
  • Asphyxia Neonatorum / physiopathology
  • Blood Flow Velocity
  • Case-Control Studies
  • Cephalometry
  • Cerebral Arteries / diagnostic imaging*
  • Cerebral Arteries / physiopathology
  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Hypoxia-Ischemia, Brain / diagnostic imaging*
  • Hypoxia-Ischemia, Brain / physiopathology
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Ultrasonography