Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging

Moderate to severe perinatal hypoxic–ischemic encephalopathy occurs in ~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability. Detailed assessment is important to help identify high-risk infants, to help families, and to...

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Main Authors: Holly Flyger, Samantha J. Holdsworth, Alistair J. Gunn, Laura Bennet, Hamid Abbasi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-11-01
Series:Neural Regeneration Research
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Online Access:https://journals.lww.com/10.4103/NRR.NRR-D-24-00970
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author Holly Flyger
Samantha J. Holdsworth
Alistair J. Gunn
Laura Bennet
Hamid Abbasi
author_facet Holly Flyger
Samantha J. Holdsworth
Alistair J. Gunn
Laura Bennet
Hamid Abbasi
author_sort Holly Flyger
collection DOAJ
description Moderate to severe perinatal hypoxic–ischemic encephalopathy occurs in ~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability. Detailed assessment is important to help identify high-risk infants, to help families, and to support appropriate interventions. A wide range of monitoring tools is available to assess changes over time, including urine and blood biomarkers, neurological examination, and electroencephalography. At present, magnetic resonance imaging is unique as although it is expensive and not suited to monitoring the early evolution of hypoxic–ischemic encephalopathy by a week of life it can provide direct insight into the anatomical changes in the brain after hypoxic–ischemic encephalopathy and so offers strong prognostic information on the long-term outcome after hypoxic–ischemic encephalopathy. This review investigated the temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries, with a particular emphasis on exploring the correlation between the prognostic implications of magnetic resonance imaging scans in the first week of life and their relationship to long-term outcome prediction, particularly for infants treated with therapeutic hypothermia. A comprehensive literature search, from 2016 to 2024, identified 20 pertinent articles. This review highlights that while the optimal timing of magnetic resonance imaging scans is not clear, overall, it suggests that magnetic resonance imaging within the first week of life provides strong prognostic accuracy. Many challenges limit the timing consistency, particularly the need for intensive care and clinical monitoring. Conversely, although most reports examined the prognostic value of scans taken between 4 and 10 days after birth, there is evidence from small numbers of cases that, at times, brain injury may continue to evolve for weeks after birth. This suggests that in the future it will be important to explore a wider range of times after hypoxic–ischemic encephalopathy to fully understand the optimal timing for predicting long-term outcomes.
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spelling doaj-art-26f15530a762408da5ef8dabcc4e8c3c2025-01-07T09:49:28ZengWolters Kluwer Medknow PublicationsNeural Regeneration Research1673-53741876-79582025-11-0120113144315010.4103/NRR.NRR-D-24-00970Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imagingHolly FlygerSamantha J. HoldsworthAlistair J. GunnLaura BennetHamid AbbasiModerate to severe perinatal hypoxic–ischemic encephalopathy occurs in ~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability. Detailed assessment is important to help identify high-risk infants, to help families, and to support appropriate interventions. A wide range of monitoring tools is available to assess changes over time, including urine and blood biomarkers, neurological examination, and electroencephalography. At present, magnetic resonance imaging is unique as although it is expensive and not suited to monitoring the early evolution of hypoxic–ischemic encephalopathy by a week of life it can provide direct insight into the anatomical changes in the brain after hypoxic–ischemic encephalopathy and so offers strong prognostic information on the long-term outcome after hypoxic–ischemic encephalopathy. This review investigated the temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries, with a particular emphasis on exploring the correlation between the prognostic implications of magnetic resonance imaging scans in the first week of life and their relationship to long-term outcome prediction, particularly for infants treated with therapeutic hypothermia. A comprehensive literature search, from 2016 to 2024, identified 20 pertinent articles. This review highlights that while the optimal timing of magnetic resonance imaging scans is not clear, overall, it suggests that magnetic resonance imaging within the first week of life provides strong prognostic accuracy. Many challenges limit the timing consistency, particularly the need for intensive care and clinical monitoring. Conversely, although most reports examined the prognostic value of scans taken between 4 and 10 days after birth, there is evidence from small numbers of cases that, at times, brain injury may continue to evolve for weeks after birth. This suggests that in the future it will be important to explore a wider range of times after hypoxic–ischemic encephalopathy to fully understand the optimal timing for predicting long-term outcomes.https://journals.lww.com/10.4103/NRR.NRR-D-24-00970magnetic resonance imagingneonatal hypoxic–ischemic encephalopathyneurodevelopmental outcomesprognostic biomarkers in neuroimagingscan timingtherapeutic hypothermia
spellingShingle Holly Flyger
Samantha J. Holdsworth
Alistair J. Gunn
Laura Bennet
Hamid Abbasi
Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
Neural Regeneration Research
magnetic resonance imaging
neonatal hypoxic–ischemic encephalopathy
neurodevelopmental outcomes
prognostic biomarkers in neuroimaging
scan timing
therapeutic hypothermia
title Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
title_full Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
title_fullStr Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
title_full_unstemmed Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
title_short Temporal dynamics of neonatal hypoxic–ischemic encephalopathy injuries on magnetic resonance imaging
title_sort temporal dynamics of neonatal hypoxic ischemic encephalopathy injuries on magnetic resonance imaging
topic magnetic resonance imaging
neonatal hypoxic–ischemic encephalopathy
neurodevelopmental outcomes
prognostic biomarkers in neuroimaging
scan timing
therapeutic hypothermia
url https://journals.lww.com/10.4103/NRR.NRR-D-24-00970
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AT alistairjgunn temporaldynamicsofneonatalhypoxicischemicencephalopathyinjuriesonmagneticresonanceimaging
AT laurabennet temporaldynamicsofneonatalhypoxicischemicencephalopathyinjuriesonmagneticresonanceimaging
AT hamidabbasi temporaldynamicsofneonatalhypoxicischemicencephalopathyinjuriesonmagneticresonanceimaging