Nadezhda Niyarah Alemao1 , Sanjeev Pahwa2 , Suraj Gowda3
BACKGROUND Hypoxic ischemic encephalopathy (HIE) is one of the major causes of mortality and morbidity in neonates in India. In spite of advancements in the field of medicine with respect to HIE, there is no satisfactory standard test for HIE. HIE can present with a multitude of manifestations in the infant brain, but one of the most obvious abnormality is the thinning of corpus callosum, which is more evident on MRI than other imaging modalities. This study was done to qualitatively assess and quantitatively measure the corpus callosum and correlate with APGAR score at birth. We wanted to correlate the morphology of corpus callosum on MRI in patients with HIE with APGAR scores and evaluate the prognostic ability of morphometric changes in corpus callosum. METHODS This is a prospective and cross-sectional study conducted in a tertiary care center in Bangalore from September 2017 to December 2018. A total of 18 clinically proven cases of HIE of age less than 10 years were included in the study. The study was carried out on T1 & T2 mid-sagittal sections of brain. The changes in corpus callosal morphometry were studied and correlated with APGAR scores and clinical outcomes. RESULTS The correlation between various dimensions and age was statistically significant for APD (p <0.05), LCC (p <0.05), GT (p <0.05), BT (p <0.05), ST (p <0.05) and FOD p <0.05). CONCLUSIONS Preterm birth adversely affects the development of corpus callosum as most of the patients were born preterm. Most common site of injury was posterior part including isthmus and body. Quantitative measurement helps in prediction of the clinical outcome of the disease. In spastic cerebral palsy, corpus callosum is diffusely thinned out, predominantly affecting posterior body, isthmus and splenium, whereas choreoathetoid cerebral palsy shows focal thinning of posterior body and isthmus of corpus callosum.
