Anoxia

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Anoxic Injury in the Newborn

The lack of oxygen to the brain is the most common cause of neurological damage in the newborn (Volpe, 1987). The term "hypoxic-ischemic encephalopathy" (HIE) is used to refer to children where there has been a reduction in the oxygen in the blood and decreased blood flow to the brain before, during or immediately after birth. Causes of HIE are mutifactorial (Spreen, Risser & Edgell, 1995) and may be due to: maternal gestational problems

• cardiac disease
• toxemia
• diabetes
• anemia

• malnourishment
• infarction of placental tissue

• birth trauma

• respiratory
• cardiac
• vascular

Cell death (i.e. neuronal necrosis) is most commonplace but damage to subcortical white matter, called periventricular leukomalacia can occur as well particularly in children born premature. Children in utero who have cardiac and/or respiratory problems, low/very low birth weight and/or have birth related complications are at higher risk for having HIE. Children with HIE display a "spectrum" of disabilities (Shaywitz & Fletcher, 1993) including motor system abnormalities (e.g. cerebral palsy), cognitive dysfunction (from mental retardation to more subtle problems in learning). Abnormalities in executive functions including organization, planning, and the ability to regulate attention, emotion and behavior (as often seen in Attention Deficit Disorder with/without Hyperactivity). Please see Spreen, Risser and Edgell (1995) for more detailed information about HIE and it's consequences.

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Scott Porter Ph.D.
Neuropsychology

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