Cerebral Metabolism in Severe Neonatal Hyperbilirubinemia
PEDIATRICSPublished 1 July 2004Open access
Floris Groenendaal, Jeroen van der Grond, Linda S. de Vries
Citations41
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TL;DR
The metabolism of the basal ganglia was examined by using proton magnetic resonance spectroscopy in 5 neonates with severe hyperbilirubinemia, and an abnormally high lactate/N-acetylaspartate ratio was found only in the neonate with neonatal magnetic resonance imaging abnormalities and subsequent cerebral palsy.
Abstract
The metabolism of the basal ganglia was examined by using proton magnetic resonance spectroscopy in 5 neonates with severe hyperbilirubinemia. A decreased N-acetylaspartate/choline ratio, indicating neuronal injury, and an abnormally high lactate/N-acetylaspartate ratio were found only in the neonate with neonatal magnetic resonance imaging abnormalities and subsequent cerebral palsy.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
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PubMedNeonatal hypoxic-ischemic encephalopathy: detection with diffusion-weighted MR imaging.
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PubMedMR findings in kernicterus.
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StrokeLongitudinal changes in proton magnetic resonance spectroscopy in cerebral infarction.
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