Neonatal Hypoxic Ischemic Encephalopathy: A Case Study

Hypoxic ischemic encephalopathy (HIE) of the neonate is a devastating consequence of a spectrum of perinatal complications. The etiology of HIE is multifactorial with the level of neurological injury influenced by both the degree of ischemic insult and the infant’s gestational age. Early diagnostic imaging provides healthcare providers with objective data following ischemic brain injury, however it is unclear which modality or combination of modalities may provide the best prognostic information. Diffusion-weighted MRI has become the diagnostic tool of choice in moderate to severe neonatal HIE with a high predictive value; however the utility of MRI alone in mild HIE remains unclear. This case review presents an infant with HIE with abnormalities in both early cranial ultrasound and EEG, yet with a post-cooling MRI without significant abnormality. This case suggests that in mild HIE, multiple imaging modalities may be a more accurate predictor for neurological outcomes than MRI alone.