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Neonatal Brain Injury and Neurodevelopmental Outcomes - Coggle Diagram
Neonatal Brain Injury and Neurodevelopmental Outcomes
NICU
Therpeutic hypothermia
Multiorgand dysfunction management
Morphine
Continous EEG
Cranial Ultrasound
MRI brain
Pathogenesis of Brain Injury
Ante-/Intrapartum
Maternal infx / fever
Chorioamnionitis
Preterm labour
FIRS Fetal inflammatory response
Lukocytes
Postpartum
Meningitis
Septicaemia
Ventrilation / CLD Chronic Lung disease
Hypoxia / hyperozia
Intraventricular Haemorrhage IVH
Investigations
Cranial US
MRI brain
Grading
Neonatal Encephalopathy
Clinically defined syndrome of disturbed neurological function in the earliest days of life in the term infant, maifested by difficulty with initiating nad maintaining
respirtion
, deoression of muscle tone and reflexes subnormal level of conciousness and often by seizures
Causes
Congenital myotonic dystrophy
Prader-wIlli
Focal cerebral infarct
MEtabolic disorders
5.
Cerebral Palsy CP
Chronic disability of central nervous system origin characterised by aberrant control of movement and posture, which appears in early life and is not a result of progressive neurologic disease
SPastic diplegia only type associated with acute interruption of blood flow
Infection and Brain Injury
Maternal infx incidence of CP/WMD
Maternal antibiotics and decreased brain injury
Increased inflammatory response in infants with brain injury
Factors Involved in Neonatal Brain Injury
Cardiac
Genetic
Hypoxia ischaemia
Infection
Coagulopathy
Thrombo-embolic
Metabolic
Neuroinflammation
Activated leukocytres may mediate neonatal brain injury
Damaged BBB
Persistent Inflammation
Improved Outcomes for Preterm Infants
Decreasing incidence and severity of cerebral palsy in prematurely bonr
Preterm Obstertrics
Anternatal steroids
Magnesium
Tocolytics
Intrapartum monitoring
Increasing incidence of C cestion
PReterm NICU
Surfactant and NCPAP
Caffeine
Recognition of nosocomial and sepsis and neurodev
DEtailed neuroimaging - MRI
Estrogen and progesterone
Gender
Male Disadvantage
Increasaed mortality and poorer neurodev outcomes
E & P replacement
Imporved neurodevelopmental outcomes
Caffeine
Caffein for Apnea of Prematurity (CAP) trial
Neurodevelopmental outcomes
Improved motor outcomes
Term Infants with Brain Injury Inverventions
Therapeutic hypothermia
Neuroprotective
Prevents secondary neuronal loss following hypoxia-ischaemia
Hazard
Leading caus of death during first weeks of life
Temperature is an independant variable in predicting death in extreme preterm babies
Room air resus
Manage seizure and multiorgan dysfunction
Inx / Inflammation
Melatonin
REgulated cricadian rhythms
Beneficial in asphyxia and sepsis
Bayleys Scaled of Infant and Toddler Development III
Gold standar 2yrs Corrected Age (CA)
Adulthood
FEwer graduate from high school
Fewer men enrolled in postsecondary study
Lower mean IQ and academic achievements
Higher neurosensory impairment
Less alcohol, drug use, pregnancy
