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Difference between revisions of "Pediatric pathology"
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→Hypoxic-ischemic encephalopathy
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{{Main|Neuropathology}} | {{Main|Neuropathology}} | ||
*Abbreviated ''HIE''. | *Abbreviated ''HIE''. | ||
===General=== | |||
*Autopsy adds some information. | *Autopsy adds some information. | ||
*Two-tone liver - suggests prior injury.<ref name=pmid15957995>{{cite journal |author=Elder DE, Zuccollo JM, Stanley TV |title=Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses? |journal=BJOG |volume=112 |issue=7 |pages=935–40 |year=2005 |month=July |pmid=15957995 |doi=10.1111/j.1471-0528.2005.00608.x |url=}}</ref> | *Two-tone liver - suggests prior injury.<ref name=pmid15957995>{{cite journal |author=Elder DE, Zuccollo JM, Stanley TV |title=Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses? |journal=BJOG |volume=112 |issue=7 |pages=935–40 |year=2005 |month=July |pmid=15957995 |doi=10.1111/j.1471-0528.2005.00608.x |url=}}</ref> | ||
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**Some hypoxic injuries that are prenatal do not occur after birth. | **Some hypoxic injuries that are prenatal do not occur after birth. | ||
***''Pontosubicular necrosis'' is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults. | ***''Pontosubicular necrosis'' is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults. | ||
**Hypoxic-ischemic insults are predominantly in the white matter. | **Hypoxic-ischemic insults are predominantly in the white matter. (???) | ||
*HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.<ref>URL: [http://emedicine.medscape.com/article/973501-overview http://emedicine.medscape.com/article/973501-overview]. Accessed on: 7 January 2011.</ref> | *HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.<ref>URL: [http://emedicine.medscape.com/article/973501-overview http://emedicine.medscape.com/article/973501-overview]. Accessed on: 7 January 2011.</ref> | ||
===Possible findings in HIE=== | |||
Hemorrhagic lesions:<ref name=pmid20626887 >{{cite journal |author=Riezzo I, Neri M, De Stefano F, ''et al.'' |title=The timing of perinatal hypoxia/ischemia events in term neonates: a retrospective autopsy study. HSPs, ORP-150 and COX2 are reliable markers to classify acute, perinatal events |journal=Diagn Pathol |volume=5 |issue= |pages=49 |year=2010 |pmid=20626887 |pmc=2914029 |doi=10.1186/1746-1596-5-49 |url=}}</ref> | |||
*Germinal matrix & intraventricular hemorrhage. | |||
*Choroid plexus hemorrhage. | |||
*Cerebellar hemorrhage. | |||
*Subpial hemorrhage. | |||
White matter lesions:<ref name=pmid20626887/> | |||
*Periventricular leukomalacia. | |||
*Subcortical leukomalacia. | |||
*Telencephalic (cerebral) leukomalacia. | |||
Grey matter lesions:<ref name=pmid20626887/> | |||
*Pontosubicular necrosis. | |||
*Infarcts of the cerebral cortex, basal ganglia, thalamus, brain stem. | |||
===Germinal matrix hemorrhage=== | ===Germinal matrix hemorrhage=== | ||