Perinatal Brain Damage

This volume is based on a highly successful conference dedicated to “Perinatal brain damage:from pathogenesis to neuroprotection ”. Neonatologists, paediatricians, paediatric neurologists, obstetricians, basic researchers involved in neurosciences, as well as rehabilitation professionals, will be interested by this ensuing publication. The volume covers pathogenic aspects of brain lesions occurring in the fetal and neonatal period, and addresses the issues of diagnostic workup and treatment.The most authoritative basic researchers, clinicians, and specialists in the field of neuroimaging, provide chapters on recent clinical advances. A subject of particular importance is the neurological vulnerability of the preterm infant, which also touches on ethical aspects of the care of high-risk preterm babies and those born from multiple pregnancies. A particularly original session focuses on cerebral white matter and the many issues related to this crucial part of the developing brain. Experts also deal with cerebral visual impairment, motor development, cognitive function, and the mechanisms underlying the neuronal plasticity of the infant’s brain. Concepts of neuroprotection are also outlined, based on pharmacological agents tested on experimental animals and the best drugs used to treat neonatal convulsions.

Now in its third edition, this is a comprehensive survey of fetal and neonatal brain injury arising from hypoxia, ischemia or other causes. The volume spans a broad range of areas from epidemiology and pathogenesis, through to clinical manifestations and obstetric care, and then on to diagnosis, long-term outcomes, and medico-legal aspects. An important theme running throughout is to highlight scientific and clinical advances that have a role to play in minimising risk, improving clinical care and outcomes.

Haemorrhage, Ischaemia and the Perinatal Brain focuses on an area of major importance in perinatal medicine. The authors, who have both made significant contributions to the subject of cerebral haemorrhage in the newborn, put forward many new and unpublished ideas throughout this monograph. By presenting a synopsis of current knowledge on all aspects of the haemorrhagic and ischaemic lesions affecting the newborn brain, they aim to provide the clinician with a logical basis for management of these devastating conditions and attempts at their prevention. The influence of altered cerebral circulatory physiology on the developing vasculature is emphasized as the key to understanding the patterns of pathology that occur at different gestational ages. A feature of the book is the chapter on vascular anatomy of the developing brain, which contains extensive new and original work illustrated in colour. Cerebral circulatory physiology, birth trauma, ischaemic lesions of the preterm and term brain damage all receive coverage, in addition to a comprehensive series of chapters on intraventricular haemorrhage. Sections on clinical management are illustrated by radiographs and CT scans from the Department of Radiology, Hospital for Sick Children, Toronto, and there are original line drawings by the authors throughout the book. Although intended primarily for the paediatrician, this book should also be of particular interest to pathologists, obstetricians and all whose work is concerned with perinatal care.

Decision making in modem obstetrics and perinatology is con trolled by a variety of different factors, but there is little doubt that in industrialized countries one of the most powerful single factors is the concern and fear of causing permanent brain damage in the unborn and newborn. The dramatic increase in the rates of abdom inal deliveries in many parts of the world is certainly rooted to a substantial part in the ~bstetrician's concern not so much about possible perinatal death, but more so about permanent brain dam age in surviving children. This trend has been accelerated by the increasing number of litigations in connection with brain damage observed in many societies. This problem itself has many aspects, but it seems evident that litigation - justified or unjustified - is one modem expression of the human and social tragedy inflicted on individuals and families by the birth of a brain-damaged child. The medical, social, and human importance of the problem is in sharp contrast to the relative lack of scientific knowledge avail able. This became very clear when the National Institutes of Health published the excellent review in 1985 on "Prenatal and Perinatal Factors Associated with Brain Disorders" and its editor, J. M.

This book provides a wealth of insights, advances and new perspectives on cell therapy for different types of neonatal ischemic disease, such as Hypoxic-Ischemic Encephalopathy (HIE), Periventricular Leukomalacia (PVL) and neonatal infarction. These diseases pose serious challenges for neonatologists and neurologists, because the severe sequelae lead to decreasing QOL for patients and their families. Accordingly, new treatments for neonatal ischemic diseases are needed all over the world. The book develops new effective therapies combined with hypothermia therapy, an established treatment for HIE. After reviewing past approaches, it presents cutting-edge topics in cell therapy, one of the most promising candidates for treating neonatal ischemic disease. Cell Therapy for Neonatal Ischemic Disease will offer readers a better understanding of the current state of the art in this field from bench to bedside, and inspire researchers and physicians to further explore this evolving therapy.

Authoritative, practical clinical text giving clear management advice on diagnosis, treatment and outcomes of all fetal and neonatal brain injuries.