Perinatal Brain Injury: Predicting Outcomes
Neonatal encephalopathy, or disturbed neurological functioning in a term infant, affects between 1 and 7 babies out of 1000 live births. It causes permanent disability in terms of cognitive and motor development in 15-20% of affected newborns. An MRI scan can help predict outcomes for infants with brain injury, with increasing levels of accuracy.
A recent study found that:
- The presence of brainstem lesions is predictive of mortality. Close to half of infants with these lesions die within the first three years of life.
- Mesencephalic and pontine lesions, alone or in combination, are also associated with high rates of mortality.
- The severity of damage to basal ganglia and thalamus (BGT) is predictive of motor impairment, with 89% accuracy.
- BGT is closely associated with cerebral palsy (CP)-the worse the BGT injury, the higher the risk of CP. Infants with severe BGT injuries have near universal rates of CP.
- Damage to the white matter, cortex, and brainstem is not associated with motor impairment.
Further study of these associations shows promise in improving outcomes.
Inder, TE. Predicting outcomes after perinatal brain injury. Nature. (October 2011).