Cerebral infarction in persistent pulmonary hypertension of the newborn
K. W. Klesh, T. F. Murphy, M. S. Scher, D. E. Buchanan, E. P. Maxwell and R. D. Guthrie
Persistent pulmonary hypertension of the newborn and its attendant
hypoxemia may place the infant at high risk for hypoxic-ischemic injury. In
19 infants with persistent pulmonary hypertension of the newborn, 16 of
whom suffered intrapartum asphyxia, we evaluated a series of
electroencephalograms (EEGs) for evidence of major focal cerebral injury,
ie, persistent voltage attenuation and/or focal electrical-seizure
activity. Of the 15 infants (78.9%) with such EEG findings, nine infants
(47% of the total population) had cerebral infarction documented by cranial
sonograms, computed tomographic scans, or autopsy findings. In eight (89%)
of the nine infants with infarction, electrical seizures were noted during
periods of muscle paralysis. We recommend (1) the use of
electroencephalography in this population, particularly during periods of
muscle paralysis, to detect underlying cerebrovascular lesions and (2) the
use of cranial computed tomography if persistent, focal EEG abnormalities
are noted.
