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Defining the brain injury paterns in neonatal hypoglycaemia

Fanny Amanda  Tian-Ming Yuan  Hui-Min Yu  
【摘要】:Objective:Hypoglycemia is one of the common metabolic problems in contemporary neonatal medicine.Imaging features of infants who su?ered from brain damage as a result of neonatal hypoglycemia were shown to have similar patterns,and to a?ect the parietal and occipital lobes most severely.Our purpose was to assess the patterns of neuroradiologic changes injury observed in patients who suffered brain damage consequent to neonatal hypoglycemia.We used magnetic resonance imaging(MRI) and cranial ultrasonography(US) scans.A secondary aim was to address the question of whether brain magnetic resonance imaging(MRI) is more informative by comparing cranial ultrasonography(US) to magnetic resonance imaging(MRI) findings.Methods:The imaging studies and clinical records of thirty three patients of neonatal hypoglycemia were reviewed retrospectively.Patterns of injury were compared with those described in the literature and those seen in neonatal hypoxic-ischemic injury.Results:We hypothesized that MRI features of neonatal hypoglycemia could be detected.MRI or US showed evidence of abnormality in 54.5%the hypoglycemic infants.The most common observed abnormal findings were injury primarily to the parietal and occipital lobes of the brain,and it showed as hyperintense lesions.In summary,the abnormalities are located predominantly on the posterior aspects of the cerebral cortex associated with periventricular white matter lesions.Rarely,abnormal signals also exist in the basal ganglia and posterior limb of internal capsule.Conclusions:MRI detected more abnormalities in the brains of neonatal hypoglycemia than US.The pattern of bilateral occipital cortical injury is quite specific for neonatal hypoglycaemia.Infants with occipital diffusion restriction were more likely to have experienced neonatal seizures,but these findings were not statistically significant.

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