Hypoxic-Ischemic Encephalopathy | CP - CerebralPalsy.org

Hypoxic-ischemic encephalopathy, or HIE, is the brain injury caused by oxygen deprivation to the brain, also commonly known as intrapartum asphyxia. The ... 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MediaInquiries ProductandServiceProviderInquiries Blog Forum LOGIN Sitemap YouarehereHomeHypoxic-IschemicEncephalopathy,orHIE,alsoknownasIntrapartumAsphyxia Hypoxic-IschemicEncephalopathy,orHIE,alsoknownasIntrapartumAsphyxia SHARE: Internalminiform ContactUsToday Call800-692-4453 StateChildWasBorn* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DistrictOfColumbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada NewHampshire NewJersey NewMexico NewYork NorthCarolina NorthDakota Ohio Oklahoma Oregon Pennsylvania RhodeIsland SouthCarolina SouthDakota Tennessee Texas Utah Vermont Virginia Washington WestVirginia Wisconsin Wyoming TermsandConditions Iunderstandandagreetothe"Terms&Conditions." * Oxygendeprivation,orintrapartumasphyxia,cancauseCerebralPalsy.Oneofthemostcommontypesofbraindamagecausedbyoxygenlossiscalledhypoxic-ischemicencephalopathy,orHIE.WhenHIEoccurs,itoftenleadstoseveredevelopmentalorcognitivedelays,ormotorimpairmentsthatbecomemoreapparentasthechildcontinuestodevelop. Whatishypoxic-ischemicencephalopathy? Braininjury–lackofoxygentothebrain,orasphyxia Hypoxic-ischemicencephalopathy,orHIE,isthebraininjurycausedbyoxygendeprivationtothebrain,alsocommonlyknownasintrapartumasphyxia.Thenewborn’sbodycancompensateforbriefperiodsofdepletedoxygen,butiftheasphyxialaststoolong,braintissueisdestroyed.Hypoxic-ischemicencephalopathyduetofetalorneonatalasphyxiaisaleadingcauseofdeathorsevereimpairmentamonginfants. Suchimpairmentcanincludeepilepsy,developmentaldelay,motorimpairment,neurodevelopmentaldelay,andcognitiveimpairment.Usually,theseverityofimpairmentcannotbedetermineduntilachildisthreetofouryearsold. AsphyxiawaslongthoughttobethecauseofCerebralPalsy,buttwostudieshaveshownthatonly9%ofcasesareadirectresultofasphyxia.Intheremaining91%ofcases,factorssuchasprematurebirth,complicationsofbirthorproblemsimmediatelyfollowingbirthcauseCerebralPalsy.Insomecases,causecannotbedefinitivelydetermined. Whendoeshypoxic-ischemicencephalopathyoccur? Hypoxic-ischemicencephalopathyismostcommoninfull-terminfants,althoughitdoesoccurinprematureinfants,aswell.Thetimingandseverityofasphyxiacanaffecttheareaofthebrainthatsustainstheinjury.Ifinjuryoccursbeforeweek35infetaldevelopment,hypoxic-ischemicencephalopathyislikelytoproduceperiventricularleukomalacia,orPVL. At40weeks,thedegreeofhypoxiacorrelatestotheareaofthebrainthatisinjured;mildhypoxiawillaffecttheparasagittalwhitematterwhileseverehypoxiaaffectstheputamen,thalamus,andparacentralwhitematter.Theareaofthebrainthatisaffectedwillhaveasignificantbearingonsymptomsthechildexperiences. Whataretheriskfactorsandcausesofhypoxic-ischemicencephalopathy? AsphyxiaisthemostsignificantriskfactorforHIE.Theseverityandlengthofoxygendeprivationaffectswhetherhypoxic-ischemicencephalopathyoccursandhowsevereitis.Eventsthatleadtoasphyxiainclude,butarenotlimitedto: Acutematernalhypotension Bloodcontaininglessoxygenduetopoorlyfunctioninglungs Cardiaccomplications Injuryfromcephalopelvicdisproportion Injuryfromumbilicalcordcomplications Impairedbloodflowtothebrainduringbirth Interruptioninbreathingorpooroxygensupply Intrapartumhemorrhage Medicalnegligence Prolapsedcord Placentalabruption Pressuretothecraniumthatchangesitshape,resultinginbleedingordecreasedbloodflow Rupturedvasaprevia Stressoflaboranddelivery Trauma Uterinerupture Fetalstrokealsoincreasesthelikelihoodofhypoxic-ischemicencephalopathyoccurring.Factorsthatcanleadtofetalstrokeinclude: Blood-clottingabnormalities Blockedbloodflowintheplacenta Malformedorweakbloodvesselsthatmayrupture Maternalhigh,orlow,bloodpressure Maternalinfection,especiallypelvicinflammatorydisease Howishypoxic-ischemicencephalopathydiagnosed? Oncehypoxic-ischemicencephalopathyissuspected,neuroimagingtechniques,especiallyMRIs,areperformedtoaiddiagnosis.Newtechniques,includingdiffusion-weightedimagingandMRspectroscopy,arethoughttobeeffectivewhenusedwithintheappropriatetimeframe. Inordertoperformthesetests,doctorsmustfirstsuspecthypoxic-ischemicencephalopathy.Ifthebirthwastraumatic,orifasignificantriskfactorsuchasfetalstrokewasknowntooccurduringpregnancy,hypoxic-ischemicencephalopathymightbesuspectedatbirth.Otherwise,parents,doctors,andcaretakerstakenoticeofvisiblesigns–impairedmotorfunction,delayeddevelopmentalmilestones,anddelayedgrowththroughclinicalobservationovertime.Astatementofseveritylevelisprovidedwhencognitivedevelopmentcanbeaccuratelyassessed. Certainsignsmayappearshortlyafterbirth.Organdysfunction,especiallyoftheheart,lungs,kidneys,liverandblood,indicatespossibleHIE.Seizuresinthefirst24hoursoflifecanalsoindicatethepossibilityofhypoxic-ischemicencephalopathy. Therearethreelevelsofhypoxic-ischemicencephalopathy:mild,moderate,andsevere. CaremustbetakentoruleoutseveralneurodegenerativeandmetabolicconditionsthatslowlyprogressandmimicCerebralPalsy. Howishypoxic-ischemicencephalopathytreated? Treatmentforhypoxic-ischemicencephalopathyfocusesonhelpingthechildadapttosymptomsthatresultfromthebraininjury.PhysicalandoccupationaltherapiesarecommonlyutilizedtotreatCerebralPalsycausedbyhypoxic-ischemicencephalopathy. Asphyxiatypicallycausespermanentdamage,whichsometimescontinuestoprogressevenaftertheasphyxiahasbeenrelieved.Topreventfurtherdamagethechildcanbemedicallymonitoredto: Maintainnormalbloodglucose Maintainnormalbloodpressure Preventorcontrolseizures Preventorminimizecerebraledema Howishypoxic-ischemicencephalopathyprevented? ThebestwaytopreventHIEistoeliminateasphyxiaduringpregnancyanddelivery.Awarenessofhypoxic-ischemicencephalopathyriskfactorscanhelpparentsandmedicalpersonnelpreventandprepareforpossiblecomplications. Preventionmeasurestobetakenduringpregnancyandatthetimeofdeliveryinclude: Learnabouttheimportanceofelectronicfetalmonitoringduringdelivery Confirmmedicalpractitionerschosentoparticipateinthedeliveryprocessarequalifiedtomonitorpregnancyandbirth Providespecificmedicaladviceandpersonalpreferencestostaffwhenarrivingatthehospital,especiallyifthemother’sdoctorisnotavailable Confirmthataqualified,certified,andproperlytrainedobstetricianandanesthesiologistareavailableduringdelivery Understandpatientrights,especiallytherighttoasecondopinion,therighttonotberushedintoadifficultdecisionwhenunnecessary,andtherighttorequestpersonalmedicalrecords Cause:Clarifyingterminology Becausetheterminologyusedissospecific,yetremarkablysimilar,termssuchasbraindefect,brainmalformationandbrainlesioncanseemconfusing.Itishelpfultoknowthedifferencebetweenthetermswhenattemptingtounderstandthecauseofcerebralpalsy. Braindevelopmentbeginsshortlyafterconception.Arelativelysmallnumberofcellsdivideandmultiplyintobillionsofcells.Asmallstripoftissuerollsintoaneuraltube.Oneenddevelopsintothebrain,theotherintothespinalcord.Throughout,differenttypesofcellsform,group,andmigratetoformvariousregionsofthebrain.Thebrainisconsideredfullydevelopedtwotofiveyearsafterbirth. Braindefectsareirregularitiesinthebrainstructurethattypicallycauseimpairment.Defectscanoccurfrommalformation,injury,illnessordisease.Thedegreeofimpairmentoftenislinkedtotheseverityofdamage.Abrainsometimescompensatesfordefects,inessence,by“rewiring”tobypassorcompensatefordamagedareas.Forthisreason,beginningtreatmentasearlyaspossibleistypicallyrecommended. Brainmalformationsaredefectsthatoccurthroughabnormaldevelopmentofthebrain.Althoughdefectscanoccuranytimeduringfetaldevelopment,inthefirst20weekstheinfantismostvulnerable;anymalformationthatoccurswhiletheneuraltubeisformingcanhavepermanentconsequences.Brainmalformationsmayresultinundevelopedareas,abnormalgrowth,malformation,orimproperbraindivisionintohemispheresandlobes. Brainlesionsaredefectsthatoccurfrominjuryordisease.Thecauseofbrainlesionsduringfetaldevelopmentincludebleedinginthebrain,infections,toxins,asphyxia,andmanyothers.Lesionstypicallyresultfromanincidentoreventthatcausesbraintissuetodie.Holes,whichoftenfillwithliquid,areleftbehindtoformcysts. LearnMore LifeExpectancy RecentDiagnosis WelcometoHolland FourTypesofBrainInjuryorMalformationThatCauseCerebralPalsy FourtypesofbraininjuryormalformationthatcauseCerebralPalsy CerebralPalsyiscausedbybraininjuryorbrainmalformationthatoccursbefore,during,orimmediatelyafterbirthwhiletheinfant’sbrainisunderdevelopment.Buthowabraininjuryaffectsachild’smotorfunctioningandintellectualabilitiesishighlydependentonthenatureofabraininjury,wherethedamageoccurs,andhowsevereitis. Cause PeriventricularLeukomalacia Damagetothewhitemattertissueinthebrain PeriventricularLeukomalacia IntraventricularHemorrhage Brainhemorrhage IntraventricularHemorrhage Hypoxic-IschemicEncephalopathy Lackofoxygentothebrain,asphyxia,orintrapartumasphyxia Hypoxic-IschemicEncephalopathy CerebralDysgenesis Brainmalformationorabnormalbraindevelopment. CerebralDysgenesis CerebralPalsyRiskFactors CerebralPalsy riskfactors   Wereyouoryourchildatrisk–before,duringorafteryourchild’sbirth? CerebralPalsyriskfactorsareevents,substancesorcircumstancesthatincreasethechancesofachilddevelopingCerebralPalsy.Theycanbeavoidable,orunavoidable.AriskfactordoesnotensureachildwilldevelopCerebralPalsy;itmeanschancesarehigherthanifthatriskfactorwasnotpresent.Likewise,theabsenceofriskfactorsdoesnotensurethatachildwillnotdevelopCerebralPalsy.Haveyoubeenexposedtothefollowingriskfactors? CerebralPalsyRiskFactors Typesofriskfactors: Asphyxiaandoxygendeprivation Bloodtypeincompatibilityorjaundice Complicationsofbirth Infection Intrauterinegrowthrestrictions Multiplebirthsandinfertilitydrugs Parentalhealthandhabits Placentacomplications Prematurebirth Traumaticbraindamage Riskfactorsvs.riskfactorcausalpathways AriskfactordoesnotensureachildwilldevelopCerebralPalsy;itmeanschancesarehigherthanifthatriskfactorwasnotpresent.Likewise,theabsenceofriskfactorsdoesnotensurethatachildwillnotdevelopCerebralPalsy. RiskFactorsandRiskFactorCausalPathways TheCerebralPalsyRiskFactorChecklist Anyexposuretoriskfactorspriortoconceptionandduringpregnancyshouldbeimmediatelydiscussedwithadoctorinordertotreatandminimizerisk.TheCerebralPalsyRiskFactorChecklisthelpsparentsdetermineiftheymayhavebeenexposedtoriskfactorsforCerebralPalsy. TheCerebralPalsyRiskFactorChecklist CALLCENTERASSISTANCE ONLINEINQUIRY RESOURCEKITS FACEBOOKFEED   CerebralPalsy.org CerebralPalsy.org CerebralPalsy.org|800-692-4432      ThiswebsitehasbeencreatedandisATTORNEYADVERTISINGsponsoredbySternLaw,PLLC.AnyuseofthiswebsiteissubjecttoourTermsofUse,PrivacyPolicyandDisclaimer.MyChild™doesnotprovidelegalservices.TheMyChild™callcenterrepresentativesarenotpermittedtoanddonotprovideanylegalormedicaladvice. 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