Hypoxic Ischemic Encephalopathy
(Cerebral Hypoxia; HIE)
Definition
| Blood Supply to the Brain |
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Causes
- Respiratory failure
- Blocked or ruptured blood vessel
- Carbon monoxide or cyanide poisoning
- Drug overdose
- Drowning
- Lack of oxygen due to smoke inhalation
- Extremely low blood pressure
- Strangulation
- Cardiac arrest
- Carbon monoxide poisoning
- High altitudes
- Choking
- Compression or injury to the trachea that reduces or stops breathing
- Complications from general anesthesia
- Diseases that cause paralysis of the respiratory organs or muscles, such as myasthenia gravis and Guillain-Barre syndrome
Risk Factors
Symptoms
-
Mild case:
- Difficulty paying attention
- Poor judgment
- Poor coordination
- Intense emotions
- Extreme drowsiness
-
Severe oxygen deprivation:
- Seizures
- Loss of consciousness
- Blue-colored skin or lips
- Difficulty breathing
Diagnosis
- Your bodily fluids may need to be tested. This can be done with blood tests.
- Images may need to be taken of your bodily structures. This can be done with:
- CT scan
- MRI scan
- Echocardiogram
- Ultrasound
- Your heart and brain activity may be tested. This can be done with:
- Electrocardiogram (EKG, ECG)
- Electroencephalogram (EEG)
- Evoked potential test
Treatment
- Life-sustaining treatment—If brain function has stopped, but damage is not yet extensive, life-sustaining treatment is given.
- Mechanical ventilation —This may be used if you are unable to breathe without assistance.
- Treatments for the circulatory system—Treatments are given to maintain heart function and control blood pressure.
- Seizure control—Medicine and general anesthesia may be given to control seizures.
- Cooling—Hypoxic brain damage is often caused by heat. Cooling blankets or other means of cooling may be applied to reduce the body's temperature.
- Hyperbaric oxygen treatment —This treatment is used in cases of carbon monoxide poisoning.
Prevention
RESOURCES
Brain Injury Association of America http://www.biausa.org
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
CANADIAN RESOURCES
Health Canada http://www.hc-sc.gc.ca
Ontario Brain Injury Association http://www.obia.on.ca
References
Brain injury secondary to carotid intervention [review]. J Endovasc Ther . 2007;14:219-231.
Hemphill J, Smith W. Neurologic critical care, including hypoxic-ischemic encephalopathy and subarachnoid hemorrhage. In: Fauci AS, Braunwald E, Kasper DL, et al. Harrison's Principles of Internal Medicine . 17th ed. New York, NY: McGraw-Hill; 2005: chap 269.
Hypoxic ischemic encephalopathy (HIE). Neurographics website. Available at: http://www.neurographics.org/2/1/1/4.shtml . Accessed February 19, 2013.
Itoo BA, Al-Hawsawi ZM, Khan AH. Hypoxic ischemic encephalopathy. Incidence and risk factors in North Western Saudi Arabia. Saudi Medical Journal . 2003;24:147-153.
