Infant Brain Ischemia

Oxygen is an essential building block for sustained life. Even a short-term loss of it can cause permanent damage to an infant’s vital functions. Infant brain ischemia occurs when an artery bleeds or is blocked, causing a disruption of the flow of oxygen to the brain. In most cases, infant brain ischemia is preventable, with the burden being on health care providers to reduce risks and act quickly if complications develop. Should doctors, nurses or other care providers fail in these obligations, parents may choose to pursue a birth injury claim in order to receive compensation.

Brain Ischemia Explained

Arteries function as pathways that channel blood into and throughout the brain. Because the brain is at the epicenter of the body’s life-sustaining operations, it needs a steady supply of life-giving oxygen. When an artery is blocked or damaged, an infant brain bleed (infant brain ischemia) can occur. If this critical situation is not addressed immediately, permanent damage to brain tissue can result. The most common form is a condition called hypoxic-ischemic encephalopathy (HIE). When an infant experiences HIE, both their oxygen and blood levels are dangerously low, leading to brain and organ damage. In the United States today, HIE from a lack of oxygen is the leading cause of infant death.

There are two types of infant brain ischemia:

• Focal Cerebral Ischemia. Occlusion or blockage occurs specifically to blood vessels in the brain, causing ischemia to that particular area. When viewed under imaging, the affected area appears abnormally dense, often with more porous sites where ischemia has also occurred.
• Global Cerebral Ischemia. Blood flow to the entire brain stops and cannot resume unless or until the baby receives medical intervention. Severe brain damage in the form of global permanent ischemia will occur if the situation is not corrected quickly. This leads to seizures, coma and even death.

The Causes of Infant Brain Ischemia

Infant brain ischemia can stem from a variety of sources. They include the following:

• Contraction of a virus.
• Genetic variables.
• Placental dysfunction.
• Umbilical cord compression.
• Maternal lifestyle factors.

Additionally, infant brain ischemia can occur as a direct result of the actions or inactions of a family’s health care providers. The most common types of birth injuries frequently leading to infant brain ischemia include the following:

• Prolonged labor.
• Nuchal cord (umbilical cord is wrapped around the baby’s neck).
• Injury following a forceps delivery.
• Failure to diagnose and treat gestational diabetes.
• Maternal infections.
• Shoulder dystocia (baby’s shoulder or shoulders get stuck in the birth canal during delivery).
• Anoxia (no oxygen for a period of time) and hypoxia (reduced oxygen for a period of time).
• Birth asphyxia.

Throughout pregnancy, labor and delivery, it is the medical care team’s responsibility to monitor the health of the baby. A vigilant team will be highly effective in preventing or quickly treating symptoms of infant brain ischemia as soon as they manifest.

Preventing Brain Ischemia

One of the most effective ways to keep this very serious condition from occurring is to understand the risk factors that make it more likely to happen. Using this knowledge throughout pregnancy and delivery can help to ensure that mother and baby receive timely, targeted care throughout the pregnancy. The most common risk factors for infant brain ischemia include:

• History of blood clotting disorders in the mother.
• Birth occurs before the baby’s lungs are fully developed.
• History of maternal infections.
• Low blood pressure in the mother.
• Diabetes.
• Placental insufficiency.
• Intrauterine growth restriction.

Infant Brain Ischemia Symptoms

In general, the symptoms of brain ischemia begin in the affected area, quickly radiating from there to other parts of the brain. Common symptoms include:

• Dizziness.
• Loss of coordination.
• Blindness in one eye.
• Vertigo.
• Weakness (in one arm or leg or on one or both sides of the body).
• Seizures.
• Lethargy.
• Loss of consciousness.

When infants experience ischemia, they are unable to communicate their symptoms. Therefore, you might only notice lethargy, loss of consciousness or loss of movement in the affected limbs or side of the body.

Treating Infant Brain Ischemia

The best treatment for infant brain ischemia depends on the cause and severity of the damage. If the effects are relatively mild, interventions such as physical therapy, occupational therapy and medications can help the baby to reach their developmental benchmarks. In the case of more serious injuries such as HIE, more intensive interventions such as surgery and neonatal hypothermia may be warranted.

Infant Brain Ischemia Prognosis

How fully a baby will recover from infant brain ischemia largely depends on their overall health and the extent of the brain damage. In some instances, parents may begin to notice more latent symptoms of impairment, including developmental delays, fine motor skill deficits and learning difficulties. These long-term consequences of infant brain ischemia may or may not be completely addressed via therapy, special education and other interventions. However, in all cases, children, their parents and their entire family will be affected over the long term.

Strategies to Cope with Your Child’s Ischemic Brain Injury

No matter what caused your child’s ischemic brain injury, there are some steps you can take to maximize the quality of life for your entire family. They include:

• Take time to research your child’s diagnosis, prognosis and treatment options.
• Take advantage of the treatment resources available to you, and follow through on recommendations and intervention plans.
• Advocate on your child’s behalf to ensure that they receive the care and resources they need.
• Set realistic goals in line with expected outcomes.
• Reach out for help and professional advice if you have questions or are struggling.
• Be receptive to alternative treatments that could improve your child’s functioning and quality of life.

If you believe your child’s infant brain ischemia was caused via the actions or inaction of the baby’s medical team, talk to a legal professional. They will use their expertise in birth injury law to evaluate your unique situation and let you know if they believe you are entitled to compensation.