What is Hypoxic Ischemic Encephalitis?

Maggie J. Hall

Hypoxic ischemic encephalitis involves brain trauma that occurs when there is an insufficient supply of blood and oxygen carried to the brain. Unlike other forms of injury, this situation generally involves large areas of the brain. Different types of encephalitis are usually caused by injury or medical conditions, including birth trauma, infections or various medical conditions. Symptoms and treatment vary depending on causative factors and extent of cellular damage.

Heart attacks may precede hypoxic ischemic encephalitis.
Heart attacks may precede hypoxic ischemic encephalitis.

Glucose and oxygen supply the energy required by the brain for cellular development during the years of physical growth and for neural transmission occurring throughout life. A devastating chain of events may occur with an interruption in this food supply, which is usually transported by circulating blood. Transmission between neurons decreases until cellular function ceases completely. Once cells become inactive, they begin to die. Chemical changes within the brain generally cause an influx of fluid, which promotes brain swelling and further cellular destruction.

Symptoms of hypoxic ischemic encephalitis in infants may include lethargy.
Symptoms of hypoxic ischemic encephalitis in infants may include lethargy.

One of the causes of hypoxic ischemic encephalitis is birth trauma in a newborn. Bruising, concussions, skull fractures and umbilical cord compression cause varying degrees of disrupted blood circulation and tissue swelling. Symptoms of this condition under these circumstances may appear as lethargy, paralysis, seizure activity or death, depending on the amount of damage incurred. Infants surviving the trauma may experience developmental delays, mental retardation or cerebral palsy. In patients of any age, heart attacks, shock and strokes all can precede hypoxic ischemic encephalitis.

Physicians may cause a chemically induced coma in older patients who are suffering from brain trauma.
Physicians may cause a chemically induced coma in older patients who are suffering from brain trauma.

Treating hypoxic ischemic encephalitis is a complex process and generally initially involves correcting the underlying cause of blood circulation disturbance. Medical staff monitor vital signs and various labs to determine when supplementation might be required. Insufficient blood oxygen levels are typically corrected with external sources if necessary. Intravenous electrolytes and glucose replacements may be administered to correct imbalances and re-nourish the brain. Pulse and blood pressure are also generally maintained within certain parameters by medications.

Some who are paralyzed or otherwise physically impaired by hypoxic ischemic encephalitis will need physical therapy throughout their lives.
Some who are paralyzed or otherwise physically impaired by hypoxic ischemic encephalitis will need physical therapy throughout their lives.

In the event of an infection, health care providers administer antibiotics and assess body temperature. Seizures may occur because of increased intracranial pressure, necessitating treatment. When hypoxic ischemic encephalitis occurs in newborns, health care professionals often induce hypothermia, as reducing body temperature prevents further brain trauma by decreasing cellular activity and nutritional requirements. Physicians may use medications to cause a chemically induced coma in older patients experiencing brain trauma for similar reasons.

Complications of hypoxic ischemic encephalitis vary depending on the length of time before receiving treatment and the severity of the trauma. Recovering patients generally experience varying degrees of cognitive, neurological and physical impairment. Patients typically require different forms of therapy once stabilized and recovering.

Encephalitis can be caused by birth trauma.
Encephalitis can be caused by birth trauma.

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