Pathophysiology and pathology of neonatal hypoxic-ischemic encephalopathy

Abstract

Hypoxic-ischemic encephalopathy (HIE) is one of the most important diseases in perinatal medicine. The pathophysiology and pathology of HIE are quite unique. The mode of cell death includes necrosis and apoptosis. Necrosis occurs in conditions of primary energy failure following the initial injury. On the other hand, apoptosis occurs days after the initial injury. The damaged area in the brain depends on the mode of injury. Severe and prolonged insults result in diffuse and marked neuronal necrosis. The cerebral cortex-deep nuclear pattern of neuronal injury appears to be related to insults that are less severe and due to partial asphyxia. The deep nuclear-brainstem pattern of injury to the basal ganglia-thalamus-brainstem occurs in infants with total asphyxia.