Drugs can exert major effects on the developing central nervous system (CNS). In the broadest sense, drugs may disturb specific developmental events in the brain and, in turn, produce teratogenic effects. In addition, maternal ingestion of certain drugs can result…
An important relationship between bilirubin and injury to the neonatal central nervous system (CNS) has been recognized for many years. The first comprehensive description of the most overt form of bilirubin encephalopathy (i.e., kernicterus) was provided by Schmorl in 1903.…
Introduction Glucose, like oxygen, is of essential and fundamental importance for brain metabolism. Indeed, because oxygen consumption is relatively low in the neonatal human brain and minimal in such areas as cerebral white matter (see Chapter 16 ), glucose supply…
Germinal matrix–intraventricular hemorrhage (GMH-IVH) is the most common variety of neonatal intracranial hemorrhage and is characteristic of the premature infant. The importance of the lesion relates not only to its high incidence but also to the essential gravity of the…
Intracranial hemorrhage in the neonatal period is an important clinical problem. Its importance relates to a relatively high frequency of occurrence, accompanied at times by serious neurological sequelae or even death. Over the last decade there have been changes in…
The presentation and etiologies of stroke in the newborn differ from those of children and adults and, in many cases, remain unrecognized. Perinatal ischemic stroke has been defined as “a group of heterogeneous conditions in which there is a focal…
The clinical aspects of neonatal hypoxic-ischemic encephalopathy (HIE) are appropriately discussed after the neuropathology (see Chapter 22 ) and pathophysiology (see Chapter 23 ), because understanding of the clinical phenomena is facilitated greatly by an awareness of the underlying pathological…
The focus in this chapter is the assessment of fetal well-being, particularly as a means for the recognition of the infant that may be at risk of hypoxic-ischemic cerebral injury. The identification of an intrauterine disturbance in gas exchange between…
INTRODUCTION This chapter addresses the clinical aspects of the encephalopathy of prematurity, a term coined to characterize the multifaceted, nonhemorrhagic white and gray matter lesions in the premature brain that reflect a combination of destructive and dysmaturational effects (see Chapters…
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…