Infant Brain Ischemia

brain damage

In all patients, brain ischemia presents in the form of constricted or complete cessation of oxygenated blood flow to the brain. In light of cerebral hypoxia emanating from constricted or completely occluded blood flow to the aerobic metabolic processes in the brain, a brain ischemia patient requires immediate oxygenation. In short, the decreased oxygen flow to the brain in cerebral hypoxia patients opens a relatively brief window of time, which if expired without restoring oxygen saturation levels to the patient’s brain, results in the brain ischemia ultimately causing patients to endure cerebral tissue death. This cascade of ischemic events posed the predicted problem of permanent brain damage in patients, alongside ongoing stroke and cardiac arrest in most cases.

The General Symptoms of Brain Ischemia

General symptoms of brain ischemia may be difficult to discern even by medical practitioners as these symptoms mimics a multitude of other similar conditions. However, seek immediate medical assistance if experiencing the following symptoms of brain ischemia in conjunction with one another, including:

  • A general feeling of malaise, muscular lethargy, and fatigue
  • Single eye blindness
  • Vertigo and dizziness
  • Decreased coordination and mobility challenges

The Two (2) Variations of Cerebral Ischemia

Depending on the relative distribution of the ischemia, brain ischemia is categorized by specialists into the two categories of cerebral ischemia:

  • Focal Cerebral Ischemia: Blood vessels in the brain become occluded, with the arterial occlusion causing the localized ischemia around the immediate focalized location of the ischemia to manifest as a dense ischemic core surrounded by dispersed, porous sites of brain ischemia.
  • Global Cerebral Ischemia: Oxygenated blood- brain circulation ceases until restored by medical resuscitation and at that juncture would be considered transient ischemia potentially resulting in brain damage and reperfusion therapy in the immediate aftermath. Or if oxygenation to the brain is left unrestored, the anoxic state results in global permanent ischemia causing the death of the patient.

In both cases, should oxygen flow to the patient’s brain be restored, medical practitioners will most likely simultaneously deliver Alteplase, an enzymatic protein serving as a tissue plasminogen activator attempting to break apart clots in ischemic stroke and other situations via thrombolysis.

Brain Ischemia and Childbirth Complications

The prevention and presentation of infant brain ischemia varies significantly in origin from adult patients. In the case of childbirth, brain ischemia presents itself with the following symptoms in neonatal patients over time, including:

  • Loss of consciousness
  • Cessation of movement
  • Seizures over a period of twenty-four (24) hours
  • Lethargy
  • Delayed or postponed achievement of infant developmental benchmarks
  • Noticeably impaired motor skill functioning over time
  • Cognitive impairment relative to peer demographics

Risk Factors Associated with Brain Ischemia and Childbirth

Per the National Institutes of Health, brain ischemia injuries in neonatal patients frequently stems from a highly complicated or distressed labor, usually one in which both mother and infant present with compounding risk factors and complications. In this regard, maternal health can and does play a large role in preventing brain ischemia risks in infants. Known risk factors and possible causes of brain ischemia in infants include:

  • blood clotting disorders in both mother and infant
  • preterm deliveries prior to full growth of lungs in utero
  • maternal infections
  • placental abruptions
  • umbilical cord complications
  • prolonged delivery
  • pressure compression on blood vessels during the birth process
  • low maternal blood pressure insufficient meet infant cerebral oxygenation requirements

In all instances of diminished or occluded flow of oxygenated cells to the brain tissues and cells of a hypoxic or anoxic infant, long-term physician considerations should include the possibility of progressively worsening symptoms as the child ages. Moreover, the presentation of a co-morbidity between infant brain ischemia and a number of movement disorders, such as cerebral palsy do exist. Ultimately, the extent of damages sustained by diminished or depleted periods of oxygen by an infant during the birthing process will likely be dictated by the specific brain region most deteriorated by brain cell and neuronal death in light of an anoxic state.

Resources:

http://www.columbianeurosurgery.org/conditions/cerebral-ischemia/

http://www.tnhealth.org/facts/Brainischemia.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC381398/

http://pediatrics.aappublications.org/content/99/6/851.short

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