Pronounced: hye-POK-sik is-KEM-ik en-sef-a-lo-path-ee
Hypoxic ischemic encephalopathy (HIE) is a condition in which the entire brain does not receive enough oxygen, but isn’t completely deprived. This particular condition refers to an oxygen deficiency to the brain as a whole, rather than a part of the brain. Although the term most often refers to injury sustained by new born infants, HIE can be used to described any injury from low oxygen.
HIE can be fatal. Within as little as five minutes of oxygen deprivation, brain cells can begin dying. The disease can also cause long-term damage, including mental retardation , delayed development, seizures , and cerebral palsy .
There are a variety of causes of HIE. Any injury and many health conditions can potentially cause oxygen deprivation to the brain. Some common causes are:
Any injury, complication, or health condition that causes the brain to have a reduction in blood flow and oxygen deprivation is a risk factor for HIE.
The doctor must work quickly to perform a physical exam. Typically, the history is the most important factor in making the diagnosis.
Tests may include the following:
Treatment depends on the underlying cause of the condition, as well as the severity of the damage to the brain. Treatment options include:
In most cases, HIE is unexpected and cannot be prevented. To prevent significant or long-term brain damage once the oxygen supply has been reduced, CPR may be administered.
RESOURCES:
Brain Injury Association of America
http://www.biausa.org/
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Ontario Brain Injury Association
http://www.obia.on.ca/
References:
Brain injury secondary to carotid intervention [review]. J Endovasc Ther . 2007;14:219-231.
Harrington DJ, Redman CW, Mouldan M, Greenwood CE. The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort [review]. Am J Obstet Gynecol . 2007;196:463.e1-5.
Hemphill J, Smith W. Neurologic critical care, including hypoxic-ischemic encephalopathy and subarachnoid hemorrhage. In: Fauci AS, Braunwald E, Kasper DL, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw-Hill; 2005: chap 269.
Hypoxic ischemic encephalopathy (HIE). Neurographics website. Available at: http://www.neurographics.org/2/1/1/4.shtml . Accessed June 2, 2007.
Itoo BA, Al-Hawsawi ZM, Khan AH. Hypoxic ischemic encephalopathy. Incidence and risk factors in North Western Saudi Arabia. Saudi Medical Journal . 2003;24:147-153.
Jain K. Hyperbaric oxygenation for the treatment of stroke. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. MedLink website. Available at: http://www.medlink.com . Accessed February 1, 2009.
Puohit D, Silverstein S. Perinatal hypoxic-ischemic encephalopathy. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. MedLink website. Available at: http://www.medlink.com . Accessed August 10, 2007.
Schulzke SM, Rao S, Patole SK. A systematic review of cooling for neuroprotection in neonates with hypoxic ischemic encephalopathy-are we there yet? BMC Pediatr . 2007;7:30.
US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001435.htm .
Last reviewed January 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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