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Hypoxic-ischemic encephalopathy (view source)
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'''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: | |||
*''Hypoxia'' = blood decreased oxygen carrying capacity,<ref name=Ref_PCPBoD8_10>{{Ref PCPBoD8|10}}</ref> e.g. [[anemia]]. | |||
*''Ischemia'' = decreased blood flow.<ref name=Ref_PCPBoD8_10>{{Ref PCPBoD8|10}}</ref> | |||
*Either ''or'' both = less oxygen delivery to tissue. | |||
==Microscopic== | |||
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".<ref>URL: [http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html]. Accessed on: 12 July 2010.</ref> | |||
**Shrunken neurons with intensely eosinophilic cytoplasm and pyknotic (shrunken) nuclei. | |||
*Pseudolaminar necrosis - (uncontrolled) cell death in the cerebral cortex in a band-like pattern,<ref>Hypoxic and Ischemic Encephalopathy. neuropathology.neoucom.edu. Accessed on: 29 December 2010.</ref> 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). | |||
===Images=== | |||
*Anoxic neurons: | |||
**[http://www.neuropathologyweb.org/chapter2/images2/2-1HIE.jpg Anoxic neurons (neuropathologyweb.org)]. | |||
**[http://moon.ouhsc.edu/kfung/iacp-olp/APAQ-Images/N1-MS-01-16.gif Anoxic neurons (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm 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 http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm]. Accessed on: 31 October 2010.</ref> | |||
<gallery> | |||
Image:Alzheimer_type_II_astrocyte_high_mag_cropped.jpg | Anoxic neurons. (WC) | |||
</gallery> | |||
*Hippocampal ischemic changes: | |||
**[http://www.neuropathologyweb.org/chapter2/images2/2-hippoHIE.jpg Hippocampus in HIE (neuropathologyweb.org)].<ref>URL: [http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html]. Accessed on: 14 January 2011.</ref> | |||
*Pseudolaminar necrosis: | |||
<gallery> | |||
Image:Cortical_pseudolaminar_necrosis_-_lfb_-_very_low_mag.jpg | Pseudolaminar necrosis - very low mag. (WC) | |||
Image:Cortical_pseudolaminar_necrosis_-_lfb_-_intermed_mag.jpg | Pseudolaminar necrosis - intermed. mag. (WC) | |||
</gallery> | |||
==See also== | |||
*[[Neuropathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Neuropathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||