Hypoxic-ischemic encephalopathy

Hypoxic-ischemic encephalopathy, abbreviated HIE, is a common neuropathology encountered at autopsy.

General

Often due to cardiac arrest, i.e. global ischemia.
Triple watershed area = parieto-occipital cortex, extrastriate occipital cortex.

Note:

Features:

Hippocampal ischemic changes (in adults):
- Loss of neurons in CA1, CA3 and CA4 +/- "cavitation".
  - Neuronal loss: No blue (nuclei) where there should be some.
  - Cavitation: bubbles/clear spaces where there should be none.
- CA2 neurons preserved/resistant.
Purkinje cell loss in the cerebellum and Bergmann gliosis.
"Anoxic neurons".^[2]
- Shrunken neurons with intensely eosinophilic cytoplasm and pyknotic (shrunken) nuclei.
Pseudolaminar necrosis - (uncontrolled) cell death in the cerebral cortex in a band-like pattern,^[3] with a relative preservation of cells immediately adjacent to the meninges.

Notes:

Neurons of subiculum in adults - usu. normal (as they are resistant to ischemic changes).

↑ ^1.0 ^1.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 10. ISBN 978-1416054542.
↑ URL: http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html. Accessed on: 12 July 2010.
↑ Hypoxic and Ischemic Encephalopathy. neuropathology.neoucom.edu. Accessed on: 29 December 2010.
↑ URL: http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm and http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm. Accessed on: 31 October 2010.
↑ URL: http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html. Accessed on: 14 January 2011.