%0 Journal Article
%T Pattern of Brain Injury Predicts Long
%A Alan Hill
%A Chinnuwat Sanguansermsri
%A Darren S. T. Wong
%A Elke H. Roland
%A Emily W. Y. Tam
%A Hao Chen
%A Jill G. Zwicker
%A Katherine E. Muir
%A Kenneth J. Poskitt
%A Peter K. H. Wong
%A Qi Xu
%A Steven P. Miller
%A Vann Chau
%J Journal of Child Neurology
%@ 1708-8283
%D 2019
%R 10.1177/0883073818822361
%X To determine if patterns of hypoxic-ischemic brain injury on magnetic resonance imaging (MRI) in term newborns predict subsequent childhood epilepsy. This retrospective cohort study includes term newborns with encephalopathy (n = 181) born between 2004-2012 and admitted to British Columbia ChildrenĄ¯s Hospital. MRI was performed between 3 and 5 days of age. The predominant patterns of hypoxic-ischemic injury were classified as Normal, Watershed, Basal Nuclei, Total, and Focal-Multifocal. Lesions in hippocampus, motor and occipital cortex were noted. Of 181 newborns, 166 (92%) survived the neonatal period, and 132 (80%) had follow-up with a median duration of 61 months (IQR: 28¨C95). Twenty-three children (17%) developed epilepsy. A higher proportion with Watershed, Basal Nuclei, or Total patterns developed epilepsy (P < .001). Injury to motor cortex, hippocampus, and occipital lobe (P < .01) were independent risk factors for epilepsy. In the adjusting logistic model, Watershed (odds ratio = 16.0, 95% CI [1.3, 197.2], P = .03) and Basal Nuclei injury (odds ratio = 19.4, 95% CI [1.9, 196.3], P = .01) remained independent risk factors. Therapeutic hypothermia did not alter these associations. Severity of brain injury and recurrent neonatal seizures are other clinical risk factors. In term newborns with hypoxic-ischemic encephalopathy, the predominant pattern of Watershed and Basal Nuclei injury are valuable predictors for development of epilepsy in later childhood
%K electroencephalography
%K hypoxic-ischemic encephalopathy
%K neonatal seizures
%K magnetic resonance imaging
%K epilepsy
%K children
%U https://journals.sagepub.com/doi/full/10.1177/0883073818822361