Intracranial hypertension syndrome and hemoglobin level in infants who had suffered cerebral ischemia in neonatal period

Abstract

Aim. To study the relationship between the clinical and neurosonographic indicators of the hypertensive syndrome and blood hemoglobin level in infants with perinatal disorders of the central nervous system. Methods. A total of 58 children with a diagnosis of «Perinatal hypoxic-ischemic brain damage in the form of hypertensive syndrome» were examined at the age of 12 months and younger. Clinical, neurological examination, neuroimaging, laboratory tests and statistical analysis were performed. Results. The majority of infants who had suffered a hypoxia during labor and had clinical and neurosonographic signs of intracranial hypertension also had different stages of blood hemoglobin level decrease. Comparing the neurosonography data and hemoglobin levels, it was found that children with anemia dominated among children with primary accumulation of cerebrospinal fluid in the interhemispheric fissure. Neurosonography revealed interhemispheric fissure widening in 30 (51.7%) of infants, ventricular system widening - in 28 (48.3%) of infants. The anemia rate was high in infants with interhemispheric fissure widening - in 19 (63.3%) out of 30 infants. Anemia was more frequent in the full-term infants with interhemispheric fissure widening - 4 (87.5%) out of 16 infants, whereas prematurely born infants with interhemispheric fissure widening had relevantly higher rate of normal hemoglobin level - 9 (64.3%) out of 14 infants. In 28 infants with ventriculomegaly 23 (82.1%) had widened anterior horns of the lateral ventricles. In 14 (59.3%) of infants with dilatation of the anterior horns of the lateral ventricles hemoglobin level was within the age-appropriate normal limits. Conclusion. Reduced hemoglobin level aggravates the symptoms of intracranial hypertension, and the continuing anemia leads to tissue edema, which leads to a rapid increase of degenerative changes in the brain, causing mental and physical retardation.

Keywords

increased intracranial pressure / hypertension syndrome / hypoxia / anemia / neurosonography

References

[1] Боконбаева С.Д., Выжиганина Н.В. Нейросонография недоношенных новорождённых детей с низкой массой тела при рождения // Вестн. Кыргыз.-Рос. славян. универ. - 2011. - Т. 11, №3. - С. 87-91.

[2] Володин Н.Н., Буркова А.С., Медведев М.И. и др. Классификация последствий перинатальных поражений нервной системы у детей первого года жизни. - М.: Российская ассоциация специалистов перинатальной медицины, 2005. - С. 67-79.

[3] Идрисова Р.М., Алискандиев А.М. Нейровизуализирующие особенности головного мозга у детей раннего возраста с судорогами при перинатальных поражениях мозга // Астрахан. мед. ж. - 2011. - Т. 6, №4. - С. 129-134.

[4] Пальчик А.Б., Шабалов Н.П. Гипоксически-ишемическая энцефалопатия новорождённых. - М.: МЕДпресс информ, 2009. - С. 6-28.

[5] Прокопцева Н.Л., Ильенкова Н.А. Железодефицитная анемия у детей: диагностика, лечение и профилактика // Сибир. мед. обозрен. - 2011. - Т. 71, №5. - С. 108-113.

[6] Caporali A., Emanueli C. Cardiovascular actions of neurotrophins // Рhysiol. Rev. - 2009. - Vol. 89, N 1. - P. 279-308.

[7] Lessmann V., Brigadski T. Mechanisms, locations, and kinetics of synaptic BDNF secretion: an update // Neurosci. Res. - 2009. - Vol. 65, N 1. - P. 11-22.

[8] Lim M., Kurian M., Penn A. et al. Visual failure without headache in paediatric idiopathic intracranial hypertension // Arch. Dis. Child. - 2005. - Vol. 90, N 2. - P. 206-210.

[9] McGregor N.E., Poulton I.J., Walker E.C. et al. Osteoclasts and hematopoiesis // Calcif. Tiss. Int. - 2010. - Vol. 86, N 3. - P. 261-270.

[10] Murabayashi M., Minato M., Okuhata Y. et al. Kinetics of serum S100B in newborns with intracranial lesions // Pediatr. Int. - 2008. - Vol. 50, N 1. - P. 17-22.

[11] Stranahan A., Mattson M. Recruiting adaptive cellular stress responses for successful brain ageing // Nat. Rev. Neurosci. - 2012. - Vol. 13. - Р. 209-216.

[12] Stamatoyannopoulos G. Control of globin gene expression during development and erythroid differentiation // Exp. Hematol. - 2005. - Vol. 33, N 3. - P. 259-271.

[13] Teng K., Felice S., Kim T. et al. Understanding proneurotrophin actions: recent advances and challenges // Dev. Neurobiol. - 2010. - Vol. 70, N 5. - P. 350-359.

[14] Williams Hematology / K. Kaushansky eds. - NY: McGraw Hill, 2010. - P. 675-707.

[15] Wiegand C., Richards P. Measurement of intracranial pressure in children: a critical review current methods // Dev. Med. Child Neurol. - 2007. - Vol. 49, N 12. - P. 935-941.

RIGHTS & PERMISSIONS

Gainetdinova D.D., Musina D.F.