Perinatal Brain Injury

This book focuses on traumatic birth injuries, predominantly of the skull and brain, as well as hemorrhagic and ischemic disorders of cerebral circulation in fetuses and newborns, providing information on each condition’s classification, incidence, etiology and pathogenesis, pathomorphology, clinic, diagnostics, prognosis, and complications. It discusses the configuration (molding) of the head, venous congestion, displacements of cranial bones, ruptures of the cerebellar tentorium during labor, and the compression of the skull and brain damage caused by obstetric operations and asynclitic insertion of the head, while also describing the importance of the periosteal stagnation of the skull to assess the delivery and explanation of tentorium tears. Intracranial hemorrhages are considered in detail, taking into account the role of the traumatic factor in their occurrence and hypoxic-ischemic brain lesions (periventricular leukomalacia, selective neuronal necrosis, multicystic encephalomalacia, etc.). Lastly, it offers the world’s first explanation of why tentorium tears occur most frequently in the left half, providing an original classification of damaged tentoria, subarachnoid and intraventricular hemorrhages, and the degree of configuration of the head in childbirth. Given the depth and breadth of its coverage, the book offers an essential resource for neonatologists, obstetricians-gynecologists, perinatologists, pediatric neurologists, pathologists, pediatricians, forensic experts and neuroimaging professionals.

This book provides a wealth of insights, advances and new perspectives on cell therapy for different types of neonatal ischemic disease, such as Hypoxic-Ischemic Encephalopathy (HIE), Periventricular Leukomalacia (PVL) and neonatal infarction. These diseases pose serious challenges for neonatologists and neurologists, because the severe sequelae lead to decreasing QOL for patients and their families. Accordingly, new treatments for neonatal ischemic diseases are needed all over the world. The book develops new effective therapies combined with hypothermia therapy, an established treatment for HIE. After reviewing past approaches, it presents cutting-edge topics in cell therapy, one of the most promising candidates for treating neonatal ischemic disease. Cell Therapy for Neonatal Ischemic Disease will offer readers a better understanding of the current state of the art in this field from bench to bedside, and inspire researchers and physicians to further explore this evolving therapy.

Now in its third edition, this is a comprehensive survey of fetal and neonatal brain injury arising from hypoxia, ischemia or other causes. The volume spans a broad range of areas from epidemiology and pathogenesis, through to clinical manifestations and obstetric care, and then on to diagnosis, long-term outcomes, and medico-legal aspects. An important theme running throughout is to highlight scientific and clinical advances that have a role to play in minimising risk, improving clinical care and outcomes.

Haemorrhage, Ischaemia and the Perinatal Brain focuses on an area of major importance in perinatal medicine. The authors, who have both made significant contributions to the subject of cerebral haemorrhage in the newborn, put forward many new and unpublished ideas throughout this monograph. By presenting a synopsis of current knowledge on all aspects of the haemorrhagic and ischaemic lesions affecting the newborn brain, they aim to provide the clinician with a logical basis for management of these devastating conditions and attempts at their prevention. The influence of altered cerebral circulatory physiology on the developing vasculature is emphasized as the key to understanding the patterns of pathology that occur at different gestational ages. A feature of the book is the chapter on vascular anatomy of the developing brain, which contains extensive new and original work illustrated in colour. Cerebral circulatory physiology, birth trauma, ischaemic lesions of the preterm and term brain damage all receive coverage, in addition to a comprehensive series of chapters on intraventricular haemorrhage. Sections on clinical management are illustrated by radiographs and CT scans from the Department of Radiology, Hospital for Sick Children, Toronto, and there are original line drawings by the authors throughout the book. Although intended primarily for the paediatrician, this book should also be of particular interest to pathologists, obstetricians and all whose work is concerned with perinatal care.

Improvements in the detection of fetal and neonatal brain injuries, advances in our understanding of the pathophysiology, cellular and molecular bases of encephalopathy, and new treatment options have all combined to produce significant changes in the management of neonatal brain disorders in the past few years. This new edition of Fetal and Neonatal Brain Injury brings the reader fully up to date with all advances in clinical management and outcome assessment. New material includes pregnancy-induced hypertension, HELLP syndrome and chronic hypertension, complications of multiple gestation, neurogenic disorders of the brain, neonatal stroke and much more. An expanded, highly illustrated chapter on structural and functional imaging of the fetal and neonatal brain is also included. An outstanding international team of highly experienced neonatologists and maternal-fetal medicine clinicians have produced a practical, authoritative clinical text that gives clear management advice to all clinicians involved in the treatment of these patients.

This title addresses fundamental questions about human brain development through the study of children with early occurring focal brain injury.

This volume is based on a highly successful conference dedicated to “Perinatal brain damage:from pathogenesis to neuroprotection ”. Neonatologists, paediatricians, paediatric neurologists, obstetricians, basic researchers involved in neurosciences, as well as rehabilitation professionals, will be interested by this ensuing publication. The volume covers pathogenic aspects of brain lesions occurring in the fetal and neonatal period, and addresses the issues of diagnostic workup and treatment.The most authoritative basic researchers, clinicians, and specialists in the field of neuroimaging, provide chapters on recent clinical advances. A subject of particular importance is the neurological vulnerability of the preterm infant, which also touches on ethical aspects of the care of high-risk preterm babies and those born from multiple pregnancies. A particularly original session focuses on cerebral white matter and the many issues related to this crucial part of the developing brain. Experts also deal with cerebral visual impairment, motor development, cognitive function, and the mechanisms underlying the neuronal plasticity of the infant’s brain. Concepts of neuroprotection are also outlined, based on pharmacological agents tested on experimental animals and the best drugs used to treat neonatal convulsions.

The advent of modern neurobiological methods over the last three decades has provided overwhelming evidence that it is the interaction of genetic factors and the experience of the individual that guides and supports brain development. Brains do not develop normally in the absence of critical genetic signaling, and they do not develop normally in the absence of essential environmental input. The key to understanding the origins and emergence of both the brain and behavior lies in understanding how inherited and environmental factors are engaged in the dynamic and interactive processes that define and direct development of the neurobehavioral system. Neural Plasticity and Cognitive Development focuses on children who suffered focal brain insult (typically stroke) in the pre- or perinatal period which provides a model for exploring the dynamic nature of early brain and cognitive development. In most, though not all, of the cases considered, the injuries affect substantial portions of one cerebral hemisphere, resulting in patterns of neural damage that would compromise cognitive ability in adults. However, longitudinal behavioral studies of this population of children have revealed only mild cognitive deficits, and preliminary data from functional brain imaging studies suggest that alternative patterns of functional organization emerge in the wake of early injury. Neural Plasticity and Cognitive Development posits that the capacity for adaptation is not the result of early insult. Rather, it reflects normal developmental processes which are both dynamic and adaptive operating against a backdrop of serious perturbation of the neural substrate.