European Journal of Molecular & Clinical Medicine

Background: Hypoxic-ischaemic encephalopathy in adults and older children (i.e. not
neonates), also known as global hypoxic-ischaemic injury, is seen in many settings and
often has devastating neurological sequelae. Magnetic Resonance imaging—has the
potential to play a significant role in diagnosis and early intervention in cases of HII. In
addition, imaging studies performed in the subacute stages of injury provide information
on the severity and extent of injury and can be helpful in predicting long-term outcome.
Material and Methods: This prospective study was conducted in a tertiary care teaching
hospital, over a period of 1 year. A total of 70 patients with history of birth asphyxia were
included in the study who underwent MRI of brain and were followed up clinically at the
end of one year to assess the neurological outcome.
Result: A total of 70 patients who fulfilled the selection criteria during the study were
enrolled. Of the 70 babies, 46 were males and 24 females, which correspond to 65.7% of
male and the rest female babies. The maximum number of patients were in the age group
of <1 year which were 47.1% (n =33) of total followed by age group 2–12 months having
34.2% (n = 24) in this group and 18.5% were more than 1 year. In our study, maximum
patients, i.e., 48.5% (n = 34) were having Apgar score of 4-6 followed by ≤3 score were
32.8% and least were > 7 score were 18.5%. In HIE 2 cases, 28.5% had involvement of
corpus callosam. 27.1% had PVL, 18.5% had basal ganglia or thalamus lesion. There was
no MRI evidence of HIE in 25.7%.
Conclusion: HIE is an important cause of morbidity and mortality in the neonatal period.
MRI show characteristic pattern of brain injury and help to exclude other causes of
encephalopathy. Imaging plays an important role in early diagnosis and timely
intervention, thereby reducing the severity of neonatal brain injury.

Background: The cause for disease and mortality throughout the infant was hypoxic ischemical encephalopathy secondary to perinatal asphyxia. It leads to permanent neuropsychological disability. Identification of a biomarker for hypoxic insult can not only help in earlier implementation of neuro-protective strategies but also in prognosticating the long term outcome.
Method: A prospective observational study conducted in IMS and SUM hospital over a period of 2 years in which 60 newborns with clinical evidence of HIE were recruited as case group. A group of 20 newborns with no evidence of HIE served as control. The serum neuron specific enolase (NSE ) levels at 4hours and 48 hours of birth of both the groups were tested and compared.
Results: The mean serum NSE levels at 4hours and 48 hours was significantly higher in the case group ( 42.43 ng/ml, 28.97 ng/ml) as compared to the control group (18.51ng/ml, 15.62ng/ml). Additionally, the mean serum NSE stages increased by the harshness of HIE in the various subgroups as per the clinical staging. ROC curve for this study has shown a good predictability for neurological outcome. For the cut off value of 40.4 mcg/l, the sensitivity was 80 % and specificity was 81.2 %.
Conclusion: Serum NSE levels can be a reliable biomarker for neurological insult in Hypoxic ischemic Encephalopathy insult in order to implement early neuroprotective strategy