Analysis of clinical and magnetic resonance features of full term newborns with hypoglycemic brain injury

Objective To evaluate the relationship between the MRI findings and clinical characteristics in full-term infants with neonatal hypoglycemia, and provide evidence for the prevention of hypoglycemic brain injury.Methods The clinical records of 17 fullterm infants with neonatal hypoglycemia who were referred to Laohekou Maternal and Child Health Hospital in Hubei Province from October 1, 2014 to October 1, 2017 were reviewed retrospectively.Results Feeding difficulty and refusal of feeding (13/17) were the most common clinical manifestations of hypoglycemia brain damage, accompanied by low response and drowsiness (9/17).Convulsions was also one of the most common clinical manifestations. It was mostly myoclonic convulsions (12/17), or only tremors of the limbs (7/17), occasionally systemic seizures (2/17). Eight cases of abnormal breathing. All of them showed apnea. The main affected areas of neonatal hypoglycemia brain injury were the occipital cortex and subcortical white matter (13/17). The bilateral occipital lobe involvement was the most common (9/17). The second was the bilateral occipital lobe (4/17). There was no unilateral lesions. Secondly, the damage of the corpus callosum was common (7/17). In addition, there were 4 cases of frontal lobe injury, all of which were diffused brain injury, and the injury site was extensively involved in many parts. Furthermore, other affected areas of hypoglycemic brain damage included focal ventricular white matter damage, bilateral visual radiation, hindquarters of the internal capsule, semicircular foramen, and thalamus.Conclusions ① Those who have clinical symptoms of hypoglycemia after birth (especially those with neurological symptoms) and those with long time of hypoglycemia have obvious hypoglycemic brain damage changes in brain MRI. ② The early stage of neonatal hypoglycemic brain injury is mainly DWI abnormal high signal, late T1WI low signal, T2WI high signal, involving more lesions, and the damage part is diverse and complex. ③ The grassroot clinicians have insufficient understanding of the dangers of neonatal hypoglycemia and hypoglycemia brain damage. Early screening and regular monitoring can prevent hypoglycemia and hypoglycemia brain damage.