Tierradentro-García LO, Elsingergy M, Nel JH, Stern J, Zandifar A, Venkatakrishna SSB, Worede F, Andronikou S. Distribution of IntraThalamic Injury According to Nuclei and Vascular Territories in Children With Term Hypoxic-Ischemic Injury.
Pediatr Neurol 2023;
138:45-51. [PMID:
36371961 DOI:
10.1016/j.pediatrneurol.2022.10.002]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND
Term hypoxic-ischemic injury (HII) on magnetic resonance imaging (MRI) is described as the basal ganglia thalamus [BGT], watershed [WS], or combined [BGT/WS] groups. We aimed to determine differences between HII groups in intrathalamic distribution.
METHODS
Delayed MRIs of children with HII and thalamic injury were reviewed. Custom tools were placed over T2-weighted and/or fluid-attenuated inversion recovery axial images to determine distribution of intrathalamic injury: (1) six subjective (whole/near-whole, central, anterior, posterior, lateral, medial); (2) four nuclear (anterior [AN], ventrolateral [VLN], medial [MN], and pulvinar [PN]); and (3) three arterial (thalamoperforating arteries [TPA], thalamogeniculate arteries [TGA], and posterior choroidal arteries [PCA]) locations. We compared the frequency of injury of the aforementioned intrathalamic locations between HII groups.
RESULTS
The 128 children (mean age at MRI 7.35 ± 3.6 years) comprised 41% (n = 53) BGT, 26% (n = 33) WS, and 33% (n = 42) BGT/WS. The VLN was the most frequent injured nuclear region (66%, n = 85), and the TGA (93%, n = 128) was the most frequent arterial region involved. VLN injury occurred more frequently in the BGT group (P < 0.001), PN in the WS group (P < 0.001), and AN (P < 0.001), MN (P < 0.001), PN (P = 0.001), and all nuclei together (P < 0.001) in the BGT/WS group. The combination of all vascular territories was significantly associated with BGT/WS (P < 0.001).
CONCLUSIONS
There are significant differences in intrathalamic nuclear and arterial injuries between the different types of HII.
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