Cerebral blood flow measurements in the neonatal brain

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Abstract

Cerebrovascular lesions and hypoxic-ischaemic brain injury are important causes of acquired neonatal brain injury in term and preterm newborn infants, which lead to significant morbidity and long-term mortality. Improved understanding of the cerebral hemodynamics and metabolism in the immature brain, and blood flow responses to physiological and external stimuli would aid understanding of the pathogenesis of neonatal brain injury. There has been increasing research interest and clinical demand to study the neonatal brain, with the exploration of the bedside and real-time measurement of cerebral hemodynamics in guiding therapy and predicting outcome. The major techniques which allow the assessment of cerebral blood flow (CBF) with relative ease at the bedside in the neonatal intensive care unit include near-infrared spectroscopy (NIRS), and transcranial Doppler ultrasonography. Diffuse optical correlation spectroscopy (DCS) is a new technique for which portable devices are currently being developed to continuously monitor relative changes in microvascular CBF at the bedside. DCS can potentially be combined with NIRS to provide continuous simultaneous measurement of changes in CBF and oxygenation, and enables the quantification of cerebral metabolic rate of oxygen. Functional studies have also been utilized with NIRS and magnetic resonance imaging to elucidate the connections between localized cortical activity and cerebral hemodynamic responses during early human development. To utilize and translate cerebral hemodynamic measurements in clinical management, future research should aim to establish clinically relevant parameters and references range for cerebral perfusion and oxygenation for the neonatal population.

Original languageEnglish
Title of host publicationPrenatal and Postnatal Determinants of Development
EditorsDavid W. Walker
Place of PublicationNew York NY USA
PublisherHumana Press
Pages69-87
Number of pages19
Volume109
ISBN (Electronic)978-1-4939-3014-2
ISBN (Print)978-1-4939-3013-5
DOIs
Publication statusPublished - 1 Nov 2016

Publication series

NameNeuromethods
Volume109
ISSN (Print)08932336
ISSN (Electronic)19406045

Keywords

  • Cerebral blood flow
  • Cerebral oxygenation
  • Diffusion correlation spectroscopy
  • Near-infrared spectroscopy
  • Neonatal brain injury
  • Neonate

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