Skip to main content
SpringerLink
Log in

Pathogenesis of Perinatal Hypoxic-Ischemic Brain Damage

  • Chapter
Perinatal Neurology and Neurosurgery

Abstract

The brain damage which results from a combination of systemic hypoxia and reduced cerebral blood flow (ischemia) in the fetus and newborn infant remains a major cause of chronic neurological disability. Hypoxia denotes a partial lack of oxygen with or without concurrent accumulation of carbon dioxide. Asphyxia is that state in which pulmonary or placental gas exchange ceases, resulting in progressive hypoxemia or anoxemia combined with hypercapnia. Ischemia is a reduction in or cessation of blood flow. It rarely occurs during the perinatal period without antecedent hypoxia or asphyxia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Little, W. J. On the influence of abnormal parturition, difficult labors, premature birth and asphyxia neonatorium on the mental and physical conditions of the child, especially in relation to deformities. Lancet 2:378–381, 1861.

    Google Scholar 

  2. Banker, B. Q., and Larroche, J. C. Periventricular leukomalacia of infancy. Arch. Neurol 7:386–410, 1962.

    Article  PubMed  CAS  Google Scholar 

  3. Christiensen, E., and Melchoir, J. Cerebral Palsy—A Clinical and Neuro- pathological Study, Clinics of Developmental Medicine. Philadelphia: Spastics International Medical Publications, J. B. Lippincott Co., 1967.

    Google Scholar 

  4. Courville, C. B. In:Birth and Brain Damage, edited by M. F. Courville. Pasedena, 1971.

    Google Scholar 

  5. Malamud, N. An etiologic and diagnostic study of cerebral palsy. In Selective Vulnerability of the Brain in Hypoxaemia, edited by J. P. Schade and W. H. McMenemy. Philadelphia: F. A. Davis, 1963.

    Google Scholar 

  6. Vannucci, R. C., and Plum, F. Pathophysiology of perinatal hypoxic- ischemic brain damage. In: Biology of Brain Dysfunction, Vol. Ill, edited by G. E. Gaull. New York: Plenum Press, 1975.

    Google Scholar 

  7. Volpe, J. J. Neurology of the Newborn, Philadelphia: W. B. Saunders Co., 1981.

    Google Scholar 

  8. Brierley, J. B., Brown, A. W., Excell, B. J., and Meldrum, B. S. Brain damage in the rhesus monkey resulting from profound arterial hypotension. 1. Its nature, distribution and general physiological correlates. Brain Res. 13: 68–74, 1969.

    Article  PubMed  CAS  Google Scholar 

  9. Brierley, J. B., Meldrum, B. S., and Brown, A. W. The threshold and neuropathology of cerebral “anoxic-ischemic” cell change. Arch Neurol. 29:361–374, 1973.

    Article  Google Scholar 

  10. Takashima, S., Armstrong, D. L., and Becker, L. E. Subcortical leuko- malacia: Relationship to development of the cerebral sulcus and its vascular supply. Arch. Neurol 35:470–472, 1978.

    Article  PubMed  CAS  Google Scholar 

  11. DeReuck, J. The human periventricular arterial blood supply and the anatomy of cerebral infarction. Ewrop. Neurol. 5:321–334, 1971.

    CAS  Google Scholar 

  12. DeReuck, J., Chattha, A. S., and Richardson, E. P. Pathogenesis and evolution of periventricular leukomalacia in infancy. Arch Neurol. 27:229–236, 1972.

    Article  PubMed  CAS  Google Scholar 

  13. Takashima, S., and Taraka, K. Development of cerebrovascular architecture and its relationship to periventricular leukomalacia. Arch Neurol. 55:11–16, 1978.

    Article  Google Scholar 

  14. Borit, A., and Herndon, R. M. The fine structure of plaques fibromyeliniques in ulegyria in status marmoratus. Acta Neuropath. 14:304–308, 1970.

    Article  PubMed  CAS  Google Scholar 

  15. Malamud, N. Status marmoratus: A form of cerebral palsy following either birth injury or inflammation of the central nervous system. J. Pediatr. 37: 610–619, 1950.

    Article  PubMed  CAS  Google Scholar 

  16. Leech, R. W., and Alvord, E. C. Anoxic-ischemic encephalopathy in the human neonatal period. The significance of brain stem involvement. Arch Neurol. 34:109–113, 1977.

    Article  PubMed  CAS  Google Scholar 

  17. Schneider, H., Ballowitz, L., Schachinger, H., Hanefeld, F., and Droszus, J. U. Anoxic encephalopathy with predominant involvement of basal ganglia, brain stem and spinal cord in the perinatal period. Acta Neuropathol. 52:287–298, 1975.

    Article  Google Scholar 

  18. Brierley, J. B. The influence of brain swelling, age, and hypotension upon the pattern of cerebral damage in hypoxia. In:Proceedings of the 5th Congress of Neuropathology, New York: Excepta Medica, 1966.

    Google Scholar 

  19. Hicks, S. P., Vacanaugh, M. C., and O’Brien, E. D. Effects of anoxia on the developing cerebral cortex in the rat.Am. J. Pathol 40:615–628,1962.

    PubMed  CAS  Google Scholar 

  20. Jilek, L., Fischer, J., Krulich, L., et al. The reaction of the brain to stagnant hypoxia and anoxia during ontogeny. Prog. Brain Res. 9:113–131, 1964.

    Article  Google Scholar 

  21. Windle, W. F. Brain damage at birth: Functional and structural modifications with time. J. Am. Med. Assoc. 200:1967–1972.

    Google Scholar 

  22. Myers, R. E. Experimental models of perinatal brain damage: Relevance to human pathology. In: Intrauterine Asphyxia and the Developing Fetal Brain, edited by L. Gluck. Chicago: Yearbook Medical Publishers, 1977.

    Google Scholar 

  23. Ranck, J. B., and Windle, W. F. Brain damage in the monkey, Macaca mulatta, by asphyxia neonatrum. Exp. Neurol 1:130–154, 1959.

    Article  PubMed  Google Scholar 

  24. Windle, W. F. Pysiology of the Fetus, Springfield, III.: Charles C Thomas Co., 1971.

    Google Scholar 

  25. Faro, M. D., and Windle, W. F. Transneuronal degeneration in brains of monkeys asphyxiated at birth. Exp. Neurol 24:38–53, 1969.

    Article  PubMed  CAS  Google Scholar 

  26. Myers, R. E., Beard, R., and Adamsons, K. Brain swelling in the newborn rhesus monkey following prolonged partial asphyxia. Neurology 19:1012–1018, 1969.

    PubMed  CAS  Google Scholar 

  27. Seltzer, M. E., Myers, R. E., and Holstein, S. F. Prolonged partial asphyxia: Effects of fetal brain water and electrolytes. Neurology 22:732–737, 1972.

    Google Scholar 

  28. Brann, A. W., and Myers, R. E. Central nervous system findings in the newborn monkey following severe in utero partial asphyxia. Neurology 25:327–338, 1975.

    PubMed  Google Scholar 

  29. Myers, R. E. Four patterns of perinatal brain damage and their conditions of occurrence in primates. In: Advances in Neurology, Vol. 10, edited by B. S. Meldrum and C. D. Marsden. New York: Raven Press, 1975.

    Google Scholar 

  30. Vannucci, R. C., and Duffy, T. E. Cerebral oxidative and energy metabolism of fetal and neonatal rats during anoxia and recovery, Am. J. Physiol. 230: 1269–1275, 1976.

    PubMed  CAS  Google Scholar 

  31. Vannucci, R. C., and Duffy, T. E. Cerebral metabolism in newborn dogs during reversible asphyxia. Ann. Neurol. 1:528–534, 1977.

    Article  PubMed  CAS  Google Scholar 

  32. Vannucci, R. C., Nardis, E. E., Vannucci, S. J., et al. Tolerance of the perinatal brain to graded hypoxemia. Neurology 30:443–444, 1980.

    Google Scholar 

  33. Rice, J. E., Vannucci, R. C., and Brierley, J. B. The influence of immaturity on hypoxic-ischemic brain damage in the rat. Ann. Neurol. 9:131–141, 1981.

    Article  PubMed  Google Scholar 

  34. Levine, S. Anoxic-ischemic encephalopathy in rats. Am. J. Pathol. 36:1–11, 1960.

    PubMed  CAS  Google Scholar 

  35. Welsh, F. A., Vannucci, R. C., and Brierley, J. B. Columnar alterations of NADH fluorescence during hypoxia-ischemia in immature rat brain. J. Cereb. Blood Flow Metahol. 2:221–228, 1982.

    Article  CAS  Google Scholar 

  36. Norman, M. G. On the morphogenesis of ulegyria. Acta. Neuropath. 53: 331–332, 1981.

    Article  PubMed  CAS  Google Scholar 

  37. Clifford, S. H. The effects of asphyxia on the newborn infant. J. Pediat. 18: 567–578, 1941.

    Article  Google Scholar 

  38. Pryse-Davis, J., and Beard, R. W. A necropsy study of brain swelling in the newborn with special reference to cerebellar herniation. J. Pathol. 109: 51–56.

    Google Scholar 

  39. Anderson, J. M., and Belton, N. R. Water and electrolyte abnormalities in the human brain after severe intrapartum asphyxia. J. Neurol. Neurosurg. Psychiat. 57:514–520, 1974.

    Article  Google Scholar 

  40. Larroche, J. C. L. Developmental Pathology of the Neonate. New York: Elsevier Science Publishing Co., 1977.

    Google Scholar 

  41. Klatzo, I. Neuropathological aspects of brain edema. J. Neuropathol. Exp. Neurol. 26:1–14,1967.

    Article  PubMed  CAS  Google Scholar 

  42. Katzman, R., Clasen, R., Klatzo, I., Meyer, J. S., Pappius, H. M., and Waltz, A. G. Report of joint committee for stroke resources: IV. Brain edema in stroke. Stroke 8:512–540, 1977.

    Article  PubMed  CAS  Google Scholar 

  43. O’Brien, M. D. Ischemic cerebral edema. A Review. Stroke 10:623–628, 1979.

    Article  PubMed  Google Scholar 

  44. Fishman, R. A. Brain edema. N. Eng. J. Med. 295:706–711, 1975.

    Article  Google Scholar 

  45. 45.McAfoos, G. L., and Vannucci, R. C. The nature and extent of cerebral edema in perinatal hypoxic-ischemic brain damage. Submitted to Pediat. Res.,1983.

    Google Scholar 

  46. Ito, U., Ohno, K., Nakamura, R., Suganuma, F., and Inaba, Y. Brain edema during ischemia and after restoration of blood flow: Measurement of water, sodium, potassium content and plasma protein permeability. Stroke 10: 542–547, 1979.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Robert C. Vannucci M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona, USA

    Richard A. Thompson M.D. , John R. Green M.D., F.A.C.S.  & Stanley D. Johnsen M.D. ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1985 Spectrum Publications, Inc.

About this chapter

Cite this chapter

Vannucci, R.C. (1985). Pathogenesis of Perinatal Hypoxic-Ischemic Brain Damage. In: Thompson, R.A., Green, J.R., Johnsen, S.D. (eds) Perinatal Neurology and Neurosurgery. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-7295-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-7295-0_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-7297-4

  • Online ISBN: 978-94-011-7295-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation