Abstract:

Perinatal brain injury (PBI) is one of the most important causes of lifelong deficits in cognition, behavior, social interaction and motor skills, as well as epilepsy. PBI encompasses, but is not limited to, hypoxic-ischemic encephalopathy (HIE), intraventricular hemorrhage, periventricular leukomalacia and encephalopathy of prematurity. PBI affects both preterm and term neonates and is a reflection of diverse and complex etiologies and initiating insults,including prenatal genetic and environmental contributions, sentinel obstetrical and perinatal events, and drug exposures. Additionally, consequences of other illnesses and events such as neonatal sepsis, cardiac defects and infantile traumatic brain injury can result in central nervous system (CNS) damage that contributes to PBI. Thus, a large majority of infants who suffer PBI experience a complex blend of CNS insults that impact multiple molecular, cellular, microstructural and ultrastructural pathophysiological mechanisms and result in cumulative deficits.