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(Cerebral Hypoxia; HIE)

Definition

Hypoxic ischemic encephalopathy (HIE) is a brain injury. It happens when the brain does not get enough oxygen.

HIE can cause be deadly. Brain cells start to die after four minutes without oxygen.

Blood Supply to the Brain
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Causes

Many health problems can cause a lack of oxygen to the brain. Some common ones are:

  • Cardiac arrest
  • Blocked or ruptured blood vessel
  • A blocked airway due to:
    • Swelling, such as from an allergic reaction
    • Trauma
    • Drug use and drug overdose
    • Drowning
    • Choking
  • Carbon monoxide poisoning

Risk Factors

The risk of HIE is higher in people who have an injury or health problem that causes the brain to have a drop in blood flow and oxygen.

Symptoms

Problems may be mild to severe, such as:

  • Clumsiness
  • Problems with focus
  • Difficulty making decisions
  • Mood swings
  • Feeling very tired
  • Signs of seizures, such as confusion and muscle jerking
  • Loss of alertness
  • Blue-colored skin or lips
  • Problems breathing

Diagnosis

A physical exam will be done. A health history is the biggest factor in making the diagnosis.

Blood tests may be done.

Pictures may need to be taken of your body. This can be done with:

Your brain and spinal cord may be tested. This can be done with:

Your heart function may also be tested.

Treatment

Treatment depends on the cause of HIE. It also depends on how severe the damage is to the brain.

You may have:

  • Life-sustaining treatment—If brain function stops, but damage is not great, then life-saving treatment is given. This may include CPR .
  • Cooling—Cooling blankets or other means of cooling may be used to lower the body's temperature.
  • Temperature control—Cooling and rewarming methods may be used.

Prevention

There are no known guidelines to prevent HIE.

RESOURCES

Brain Injury Association of America  http://www.biausa.org 

National Institute of Neurological Disorders and Stroke  https://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Ontario Brain Injury Association  http://www.obia.on.ca 

References

Busl KM, Greer DM. Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms. NeuroRehabilitation. 2010;26(1):5-13.

Hypoxic ischemic encephalopathy (HIE). Neurographics website. Available at: http://www.asnr.org/neurographics/2/1/1/4.shtml. Accessed October 1, 2020.

Hypoxic-ischemic encephalopathy in adults. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/hypoxic-ischemic-encephalopathy-in-adults . Accessed October 1, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2020
  • Update Date: 10/01/2020