Neuroprotection In The Newborn

This issue of Clinics in Perinatology devoted to Neuroprotection in the Newborn examines the physiology of brain injury, detection of brain injury, protection and treatment of brain injury: hypothermia, and pharmacologic methods of neuroprotection. Drs. Alan Spitzer and Robert White have assembled a team of authoritative authors to pen articles on Protection of cerebral perfusion and oxygenation during the first few days of life in high-risk preterm infants, Cytokines and perinatal brain injury, Use of aEEG for assessing neonatal neurological injury, Anatomic changes and imaging in assessing brain injury, Nutritional/metabolic brain injury during the neonatal period, Brain cooling for neuroprotection - the pros and cons, Brain cooling for the preterm infant, Supportive care for infants during brain cooling, Technical aspects of starting a cooling program, Prevention of IVH in the preterm infant, iNO and neuroprotection, and Neuroprotection during heart surgery in infants.

It is with great pleasure that I present to you this book. At the present time, physicians and scientists are working feverishly to find novel strategies for neuroprotection in human preterm and term hypoxic newborns. Cerebral hypoxia-ischemia and asphyxia present a great challenge to all of us concerned with the deleterious consequences that manifest as cerebral dysfunction, mental retardation, and cerebral palsy. This book entitled Mechanisms of Hypoxic Brain Injury in the Newborn and Potential Strategies for Neuroprotection will be of great interest to physicians, clinician-scientists, and researchers in a number of disciplines including Pediatrics, Neonatal-Perinatal Medicine, Developmental Biology, Neurology, Pediatric Neurology, Obstetrics and Gynecology, Neuroscience, Developmental Neuroscience, Developmental Neurochemistry, and to everyone interested in the developing brain . The information presented in this book will be appropriate to residents, clinical fellows, pre- and post-doctoral fellows, faculty of basic science departments, faculty of clinical departments, and to the most advanced researchers in the field of hypoxic ischemic brain injury in the fetus and the newborn. I would like to thank sincerely my colleagues and contributors to this book for their excellent efforts and extremely valuable time. Each contributor to this book is a pioneer in his or her field: the contributions are superb. As a reader, you will find that the authors of this book are from different parts of the world and that this book presents the forefront of cutting-edge global research and developments in the field of hypoxic brain injury in newborns. Finally, I would like to thank my wife Ira Mishra, whose constant support and patience have been invaluable in helping to produce not just this book but thirty years of my research investigations on the mechanisms of hypoxic injury in the developing brain.

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.

Guest Editor Adre du Plessis addresses Neonatal Neurology in this issue of Clinics in Perinatology, a companion to his September 2009 issue on Fetal Neurology. Mechanisms and management of acute brain injury is reviewed, including articles on Systemic and cerebral transitional hemodynamics in premature infants, Hypoxic-ischemic brain injury in the term infant, Neuroprotection in the newborn infant, Intracranial hemorrhage in the premature and term newborn, Infection-inflammatory mechanisms of brain injury in the newborn, Neonatal stroke, and Neonatal seizures. Next, Neurodiagnostic advances for the newborn infant is explored, with articles covering, Advanced brain MRI techniques, Advances in Near Infrared Spectroscopy, and Bedside electrocortical monitoring. The issue closes with a section devoted to Longterm neurologic outcome: Mechanisms of dysfunction and recovery, with articles on Longterm outcome in premature infants, Mechanisms of Cerebral Plasticity, The longterm effects of neonatal seizures, Constraint-induced therapy: Plasticity in practice, and Neonatal brain injury and autistic spectrum disorders in survivors.

Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the most challenging aspects of neonatal care, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today’s practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient. Stay fully up to date in this fast-changing field with Neurology, 3rd Edition. The most current clinical information, including new coverage of genetics and pharmacology, early diagnosis and targeted treatment of neonatal-onset epilepsies, and the impact of congenital heart diseases on brain development. Considerations of ongoing research regarding the basic mechanisms contributing to perinatal brain injury, which has in turn facilitated the introduction of targeted strategies in many areas. Consistent chapter organization to help you find information quickly and easily. The most authoritative advice available from world-class neonatologists who share their knowledge of new trends and developments in neonatal care. Purchase each volume individually, or get the entire 7-volume set! Gastroenterology and Nutrition Hematology, Immunology and Genetics Hemodynamics and Cardiology Infectious Disease and Pharmacology New Volume! Nephrology and Fluid/Electrolyte Physiology Neurology The Newborn Lung

This landmark book, a reference work now in its second edition, provides healthcare practitioners in neonatology with an up-to-date, comprehensive source of readily accessible practical advice that will assist in the expert management of patients and their diverse illnesses. Leading experts in their fields discuss the underlying causes and mechanisms and all aspects of the treatment of the full range of neonatal diseases and abnormalities, citing the evidence base whenever appropriate. In addition, detailed information is provided on epidemiology and fetal medicine; therapeutic issues such as the organization of care, transport services, and home care after discharge; legal issues; nutrition; and the consequences of medication use during pregnancy, maternal drug abuse and smoking, and maternal diabetes. The inclusion of summaries, tables, and carefully selected guidelines and recommendations will supply practitioners with quick references and instant solutions during daily practice. The book will be a superb resource for all involved in the care of newborn babies, including neonatologists, pediatricians, pediatric surgeons, anesthesiologists, midwives, and nursing staff. It is published within the SpringerReference program, which delivers access to living editions constantly updated through a dynamic peer-review publishing process.

Endogenous neuoprotection is a phenomenon where a brief episode of ischemia renders the brain resistant against a subsequent longer-asting ischemia event. Experimentally, the author was able to model hypoxic preconditioning in animal model. Increasing knowledge of this endogenous neuroprotectin by ischemic tolerance may help to minimize neuronal damage following ischemic stroke and hypoxic encephalopathy. This book is, therefore, the first overview of this important topic and will certainly influence further investigations in clinical and neuroscience research.