MRI findings of brain damage due to neonatal hypoglycemia

Abstract

Objective To report the MRI findings of brain damage obsenrved in neonatal patients who suffered from isolated hypoglycemia and to explore the value of diffusion-weighted imaging(DWI) inearly detection of neonatal hypoglycemic brain iniun,. Methods Twelve neonates with isolated hypoglycemia(10 of the 12 were diagnosed to suffer from hypoglycemic encephalopathy)were enrolled in this study.They were first scanned at age from 3 days to 10 days with Tl WI,T,WI and DWI(b is 0 s/mm2,1000 s/mm2),and 4 of them were then scanned from 7 days to 10 days following the initial scan.All acquired MR images were retrospectively analysed.Results First series of DWl images showed distinct hyperintense signal in 11 cases in several areas including bi lateral occipital cortex(2 cases),right occipital cortex(1 case),left occipital cortex and subcortical white matter(1 case),biIateral occipital cortex and flubcortical white matter(2 cases),bilateral parieto-occipital cortex(2 cases),bilateral parieto-occipital cortex and subcortical white matter(2 cases),the splenium of corpus catlosum(4 cases),bilateral corona radiata(2 cases),left eaudate nucleus and globus pallidus(1 case),bilateral thalamus(1 case),bilaterally posterior limb of internal capsule(1 ease).In the initial T1 WI and T2,WI images,there were subtle hypointensity in the damaged cortical areas(3 cases),hyperintensity in the bilaterally affected occipital cortex(1 case)on T1 weighted images,and hyperintensity in the affected cortex and subcortieal white matter with poor differentiation on T2 weighted images.The followed-up MRI of 4 cases showed regional encephalomalaeia in the affected occipital lobes(4 cases),slightly hyperintensity on T2 weighted images in the damaged occipital cortex(2 cases),extensive demyelination(1 case).disappearance of hyperintensity of the splenium of corpus callosum(1 case),and persistent hyperintensity in the splenium of corpus callosum (1 case)on T2 weighted images.Conclusion The findings suggest that posterior parieto-occipital regions are most frequently injured in neonatal period due to severe hypoglycemia.DWI is a useful technique in the early detection and evaluation of hypoglycemic brain injury of neonates. Key words: Hypoglycemia; Brain injuries; Infant,newborn; Magnetic resonance imagingDOI:10.3760/cma.j.issn.1005-1201.2009.01.012