HIE or Hypoxic-ischemic encephalopathy is a condition where the brain does not receive enough oxygen.
This can occur if there is a problem getting the blood to the brain, for example if the heart is not pumping adequately, or if there is not enough oxygen in the blood which can occur if someone is not breathing adequately.
The extent and location of brain injury depends on how severe the loss of oxygen, and amount of time the oxygen has not been available to the brain. It also depends upon the age of the baby.
Hypoxic Ischemic Encephalopathy in Neonates
Babies born prior to the expected delivery time are most susceptible. If HIE occurs before 35 weeks of birth it results in cysts in the brain tissue called periventricular leukomalacia or PVL.
Hypoxic ischemic encephalopathy can occur in intrauterine life before birth, at the time of birth and after birth. There are many risk factors including:
- Low blood pressure in the mother
- Forceps or breech delivery
- Umbilical cord prolapse
Short Term and Long Term Effects of HIE
There are short term and long term effects of HIE. Short term include bleeding in the brain and seizures. Long term effects depend on severity and location and can range from epilepsy to delayed milestones and motor movement disorder like cerebral palsy.
Detecting Hypoxic Ischemic Encephalopathy
Sometimes it can be difficult to detect an episode of HIE. In hospital or intensive care it can be detected by a change in feeding and breathing pattern. The body may become stiff or floppy ,or the patient may experience hypoxic ischemic encephalopathy and seizures.
Hypoxic Ischemic Encephalopathy in Children
For older children an eyewitness may have to give details as usually the patient would not remember the episode.
Hypoxic Ischemic Encephalopathy MRI
When HIE is suspected, imaging can play an important role using ultrasound, CT or MRI. MRI is the preferred method as there is no radiation and is excellent in detecting the extent of HIE in the brain.
MRI may give us important information about the diagnosis about any complications and determine extent of injury with possible long term effects. A second medical opinion is best practice when analysing the results of the MRI scan for such a complex condition.