Brain damage in asphyxiated newborn infants: early diagnosis. A follow-up study]

Cranial computerized tomographic (CT) scan and serum creatine phosphokinase-BB(CPK-BB) determination were done in 85 asphyxiated newborn infants, in some of them, long-term follow-up study including neurodevelopmental assessment and CT scan were also carried out. The types of early brain damage after perinatal asphyxia included intraparenchymal hemorrhage (IPH), periventricular-intraventricular hemorrhage (PV-IVH), subarachnoid hemorrhage (SAH) and brain edema (BE). Serum CPK-BB levels were elevated within 24 hours after the events of asphyxia, and correlated to the severity of brain damage. These findings were helpful in the early diagnosis of brain damage and estimating its severity and prognosis. The types and severity of brain damage were obviously related to prognosis. The prognosis of infants after SAH and BE were better than those of infants with PV-IVH, and infants with IPH showed the poor results. Follow-up CT scans were performed in 30 infants with brain damage. Abnormal changes included ventricular sulcus dilation, leukomalacia, cyst formation (pseudocyst) and porencephalic cavitation (porencephaly).