| ObjectiveTo document associated factors of neonatl bypoglycemic brain injury, brain injury patterns identified on early MRI scans and their relationships to clinical fetures.MethodsWe studied 54 infants with early brain MRI scans after neonatal hypoglycemia without evidence of hypoxic-ischemic encephalopathy,severe cerebral hemorrhage, intracranial infection, encephalodysplasia, congenital metabolic encephalopathy, septicemia, endocrine encephalopathy.31 infants with abnormal MRI scans, clinical data were compared with 23 infants with normal MRI scans,to identify associated factors.Statistic analysis was performed using a t test,Mann-Whitney test and x2 test.P values of less than 0.05 were regarded statistically significant.ResultsRegion of birth (x2=6.755, P＜0.01),maternal diabetes mellitus(x2=11.875, P＜0.01), difficulty of feeding (x2=22.605, P<0.01),abnormallity of consciousness(x2=34.822, P＜0.01),abnormallity of respiratory (x2=21.888,P<0.01),hypomyotonia (x2=14.552, PP0.01), convulsion (x2=29.797, P＜0.01) were related to neonatal hypoglycemic brain injury. First time of feeding (Z=-3.771,P<0.01),the time hypoglycemia apparented (Z=-4.287,P<0.01), lowest level of hypoglycemia(t=-3.354,P<0.01), apparent duration of hypoglycemia(Z=-3.615,P<0.01) were related to neonatal hypoglycemic brain injury. All brain injury patients had cortical injury in occipital and parietal lobe,16 presented widespread cortex involvement. Encephalomalacia were found in 8 patients who received a second MRI scan. Deep white matter involvement include 1 with lesions in centrum ovale,14 in corpus callosum,2 showed posterior limb of internal capsule injury,1 in periventricular white matter,2 presented some involvement of globus pallidus on DWI who received a second MRI scan. ConclusionNeonatal hypoglycemic brain injury relates to the severity of hypoglycemia,but Early and effective intervention is important to avoid brain injury. Accompanied symptoms of neonatal hypoglycemia means hypoglycemic brain injury happened. The pattens of neonatal hypoglycemic brain injury are more varied, widespread cortex often accompanied with severe symptoms and progress to encephalomalacia. Deep white matter and deep grey matter involvements happens in patients with ischemia and hypoxia.Localized to the parietal and occipital cortex injury is reversible. |
