Hypoxic Ischemic Encephalopathy
Condition
(Cerebral Hypoxia; HIE)
Definition
Hypoxic ischemic encephalopathy (HIE) is a brain injury. It happens when the brain does not get enough oxygen.
HIE can be deadly. Brain cells start to die after 4 minutes without oxygen.
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Causes
Many health problems can cause a lack of oxygen to the brain. Some common ones are:
- Cardiac arrest
- Blocked or ruptured blood vessel
- A blocked airway due to:
- Swelling, such as from an allergic reaction
- Trauma
- Drug use and drug overdose
- Drowning
- Choking
- Carbon monoxide poisoning
Risk Factors
The risk of HIE is higher in people who have an injury or health problem that causes the brain to have a drop in blood flow and oxygen.
Symptoms
A person with HIE may have:
- Clumsiness
- Problems with focus or trouble making decisions
- Mood swings
- Fatigue
- Signs of seizures, such as confusion and muscle jerking
- Loss of alertness
- Blue-colored skin or lips
- Problems breathing
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done.
Blood tests may be done.
Images may need to be taken of the brain and body. This can be done with:
The brain and spinal cord may be tested. This can be done with:
- Electroencephalogram (EEG)
- Evoked potential tests
Heart function may also be tested.
Treatment
The goal of treatment is to get oxygen to the brain to prevent more damage. How this is done depends on why oxygen is not getting to the brain.
Some things the doctor may do are:
- Treatments like CPR to get blood and oxygen flowing to the brain again.
- Using cooling blankets or other means of cooling to lower the body's temperature.
- Using cooling and rewarming methods.
Prevention
HIEs cannot be prevented.
Brain Injury Association of America
National Institute of Neurological Disorders and Stroke
CANADIAN RESOURCES:
Health Canada
Ontario Brain Injury Association
Brain Injury Association of America
National Institute of Neurological Disorders and Stroke
CANADIAN RESOURCES:
Health Canada
Ontario Brain Injury Association
References
- Busl, K.M. and Greer, D.M. Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation, 2010; 26 (1): 5-13.
- Hypoxic-ischemic brain injury in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypoxic-ischemic-brain-injury-in-adults.
- Hypoxic ischemic encephalopathy (HIE).UFHealth website. Available at: https://ufhealth.org/hypoxic-ischemic-encephalopathy-hie.
Contributors
- Rimas Lukas, MD
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