Utility of MRI in Neonatal Hypoglycemic Brain Injury (NHBI) – Case Series
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 4
Abstract
To assess the role of MRI in neonatal hypoglycemia, a prospective study was done on 10 neonates in the Department of Radiodiagnosis in Dr. D. Y. Patil Medical College and Research Centre, Pimpri, Pune, who were clinically suspected to have hypoglycaemia. Out of the 10 cases examined : 4 patients showed restricted diffusion in parieto-occipital lobes involving both grey and white matter, 1 patient showed restricted diffusion in splenium of corpus callosum, 1 patient showed multiple small areas of hemorrhage in both cerebral hemispheres, 2 patients showed cortical laminar necrosis with restricted diffusion of splenium, 1 patient showed restricted diffusion in splenium and parieto-occipital lobes with hemorrhage in cerebral hemispheres, 1 patient showed restricted diffusion in splenium with hemorrhagic foci in cerebral hemispheres. 2 of these patients also showed unmyelinated posterior limb of internal capsule. Neonatal hypoglycemia can occur in preterm infants, small-for-gestational-age infants, and infants of diabetic mothers. Persistent or recurrent hypoglycemia can result in neonatal permanent brain injury like vision disturbance, occipital lobe epilepsy, cerebral palsy and cognitive impairment. Injury of splenium of corpus callosum along with involvement of bilateral parieto-occipital cortex and subcortical white matter are the most commonly observed injury patterns in neonatal hypoglycemia. MR imaging can be reliably used in the absence of laboratory values to suggest hypoglycemic brain injury. MRI, especially DWI with ADC mapping is extremely useful in detection of hypoglycemic insult in neonate. Restricted diffusion in the splenium of corpus callosum, parieto-occipital lobes and hemorrhagic foci in cerebral hemispheres are useful signs in detecting neonatal hypoglycemia.
Authors and Affiliations
Dr. Sanjay M. Khaladkar, Dr. Aarushi Gupta, Dr. Rajesh S. Kuber, Dr. Akshay Waghmode, Dr. Rajshree Dhadve, Dr. Dwaram Jyoti Reddy
Keywords
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