HOW IMPORTANT IS PERINATAL ASPHYXIA IN THE CAUSATION OF BRAIN INJURY

Recent epidemiologic data demonstrate that prenatal factors play a maj or role in the genesis of brain injury in childhood, e.g., cerebral pa lsy and mental retardation, Nevertheless, there is extensive experimen tal, clinical, and neuroimaging data that show that acute, intrapartum hypoxic-ischemic insult is an important factor in the genesis of irre versible brain injury, especially in term newborns. The precise timing of onset of hypoxic-ischemic cerebral injury in premature newborns ma y be more difficult to establish, and postnatal complications (e.g., i ntraventricular hemorrhage, posthemorrhagic hydrocephalus) undoubtedly play a major role, When the potential deleterious consequences of sev ere, intrapartum asphyxia are minimized, there is a risk that importan t opportunities for prevention of newborn cerebral injury may be misse d. In this context, new techniques may permit rapid, in vivo delineati on of the critical processes involved in newborn hypoxic-ischemic brai n injury that are key factors for the development of effective prevent ive and interventional strategies. (C) 1997 Wiley-Liss, Inc.