Abstract
Intracranial hemorrhage (IH) is a major problem of neonatal intensive care. The incidence of IH is typically asymptomatic and cannot be effectively detected by standard diagnostic methods. The mechanisms underlying IH are unknown but there is evidence that stress-induced disorders in adrenergic regulation of cerebral venous blood flow (CVBF) are among the main reasons. Quantitative and qualitative assessment of CVBF could significantly advance understanding of the nature of IH in newborns. In this work, we analyze variations of CVBF in newborn rats with an experimental model of stress-induced IH and adrenaline injection. Our analysis is based on the Doppler optical coherence tomography (DOCT) and a proposed adaptive wavelet-based approach that provides sensitive markers of abnormal reactions of the sagittal vein to external factors. The obtained results demonstrate that the incidence of IH in newborn rats is accompanied by a suppression of CVBF with the development of venous insufficiency and areactivity to adrenaline. We introduce a numerical measure θ, quantifying reactions of CVBF and show that the values θ < 1.23 estimated in the low-frequency (LF) spectral range corresponding to the sympathicus indicate abnormal reactions associated with the development of IH. We conclude that the revealed areactivity of the cerebral veins to adrenaline represents a possible mechanism responsible for pathological changes in CVBF.
Highlights
Intracranial hemorrhage (IH) is a major reason of neonatal morbidity and mortality that was revealed in about 50% premature infants who were born at 24–26 weeks gestation, in 15–30% full-term babies with deep hypoxia and with birth trauma.[1,2,3] The incidence of IH is typically asymptomatic and cannot be e®ectively detected by standard diagnostic methods
Relaxations of the sagittal vein are accompanied by a reduced velocity of CVBF that is more pronounced in rats with IH than in healthy animals (3:03 Æ 0:05 mm/s versus 6:09 Æ 0:03 mm/s, p < 0:05)
Unlike the typically used continuous wavelet transform with empirically selected parameters, this adaptive approach enables us to perform an optimal choice of the parameter set aiming to reveal the most essential distinctions between normal and pathological dynamics of CVBF
Summary
Intracranial hemorrhage (IH) is a major reason of neonatal morbidity and mortality that was revealed in about 50% premature infants who were born at 24–26 weeks gestation, in 15–30% full-term babies with deep hypoxia and with birth trauma.[1,2,3] The incidence of IH is typically asymptomatic and cannot be e®ectively detected by standard diagnostic methods. Absence of e®ective diagnostic technologies for early recognition of IH explains a high percentage of neonatal death and less optimistic neurologic prognosis in infants after IH.[18,19,20,21] Development of noninvasive techniques to provide diagnostics of IH risk is of high importance. For this purpose, we consider here an approach based on the optical coherence tomography (OCT). We propose an adaptive wavelet-based approach aiming to reveal instantaneous characteristics of blood °ow dynamics from OCT data and to diagnose abnormalities in the dynamics of brain vessels
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