This book is an excellent summary of contemporary knowledge of the
clinical pathogenesis and manifestations of hypoxic-ischemic
encephalopathy and birth asphyxia.
This text presents a state-of-the-art review of asphyxial brain
injury to the fetus and new born, a leading source of both neonatal
mortality and long-term neurologic disability. Beginning with an
historical overview of birth-related injury, followed by an
epidemiologic review of the relationship of birth injury to later
neuromotor disability, it provides a detailed analysis and
exhaustive review of each aspect. The contributors are among the
most knowledgeable international authorities in the field; they
have synthesized a uniformity of medical and scientific quality,
clarity of style, and thoroughness of scope. Continual emphasis is
placed on the material's relevance and usefulness to clinicians;
equally important is the emphasis on communication between
clinicians and basic neuroscientists.
The book's first section provides an overview of the history and
epidemiology of birth-related brain injury and its relationship to
later neuromotor disability. The next section examines mechanisms
of injury from a cellular and molecular perspective, including: and
examination of the neurotoxic cascade; cytokine-mediated brain
damage; the roles of glucose and acidsosis on neuronal injury;
cerebral energy depletion; apoptosis and necrosis; the roles of
neuronal and vascular nitric oxide; and free radical-mediated
processes. The following section deals with clinical birth
asphyxia, and includes chapters on prenatal injury, intrapartum
injury, clinical management, neuroimaging, and hypothermia as a
potential intervention. The lastsection discusses the medico-legal
aspects of asphyxial brain injury. Throughout the various chapters,
the authors have preserved the important context of normal
development, with an emphasis on the need for fundamental
pathogenetic data, to allow for rational approaches to prevention
and treatment.
The task of paediatricians and neonatologists in coming years
will be to better understand the mechanism of brain damage, the
prediction of disability, and the introduction of efficacious
neuroprotective strategies. To that end, this volume deserves wide
recognition by physicians in all disciplines related to neonatal
care, including paediatricians, neonatologists, neurologists,
obstetricians, family practitioners, nurses and legal counsel.
General
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