Hypoxic-ischemic encephalopathy (HIE) in the perinatal period represents an important portion of neonatal neurology. To understand the features of HIE, which are discussed extensively in this unit, it is necessary to be cognizant of the physiological and biochemical derangements that…
INTRODUCTION Seizures are distinctive and frequent manifestations of neurological disease in the neonatal period. The incidence of seizures varies with gestational age and birth weight. Estimated incidences range from 5 to 15/1000 live births in very-low-birth-weight infants to 1 to…
INTRODUCTION Though progress in newborn medicine since the 1960s has led to the dramatic increase of survival in treated patients, it may be offset by an increase in neurodevelopmental impairments in these patients. Moreover, these developmental issues are not always…
CEREBROSPINAL FLUID EXAMINATION Examination of the cerebrospinal fluid (CSF) is an important part of the evaluation of a wide variety of neurological disorders, as noted in appropriate chapters throughout this book. In this section, we focus principally on normal CSF…
INTRODUCTION The neurological evaluation of the newborn comprises, as it does at other ages in pediatric medicine, the history, physical examination, and appropriate specialized studies. Appropriate neurodevelopmental follow-up is the critical next step in the neurological evaluation. The history is…
ENDOCRINE DISORDERS IN PREGNANCY AND THE DEVELOPING FETAL BRAIN Normal fetal brain development is dependent on a highly orchestrated and dynamic endocrine milieu that evolves across gestation. Early in gestation the endocrine environment of the fetus is supported and regulated…
DEVELOPMENT OF NORMAL PLACENTAL STRUCTURE AND FUNCTION The normal placenta is far more than a mere conduit for nutrient and waste exchange between the mother and fetus. Rather, it is a highly specialized organ with multiple complex and interrelated functions,…
INTRODUCTION Evaluation of the fetal brain is, for obvious reasons, heavily dependent on specialized imaging techniques that have entered the clinical domain over the past five decades. Since its entry into the clinical domain in the late 1960s and early…
Myelination is characterized by the acquisition of the highly specialized myelin membrane around axons. The time period of myelination in the human is long, beginning mainly in the second trimester of pregnancy and continuing into adult life. Myelination in the…
NORMAL DEVELOPMENT Organizational events occur in a peak time period from approximately the fifth month of gestation to several years after birth. However, these complex processes may continue for many more years in human cerebrum. The major developmental features include…