{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:11:27Z","timestamp":1770739887822,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T00:00:00Z","timestamp":1364774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Patterns of injury in term\u2010born infants with neonatal encephalopathy following hypoxia\u2013ischaemia are seen earlier and are more conspicuous on diffusion\u2010weighted magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) than on conventional imaging. Although the prognostic value of <jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> in infants with basal ganglia and thalamic damage has been established, data in infants in whom there is extensive injury in a watershed distribution are limited. The aim of this study was to assess cognitive and functional motor outcome in a cohort of infants with changes in a predominantly watershed distribution injury on neonatal cerebral <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>, including <jats:styled-content style=\"fixed-case\">DWI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> findings in infants with neonatal encephalopathy following hypoxia\u2013ischaemia were evaluated retrospectively. Twenty\u2010two infants in whom <jats:styled-content style=\"fixed-case\">DWI<\/jats:styled-content> changes exhibited a predominantly watershed distribution were enrolled in the study (10 males, 12 females; mean birthweight 3337g, 2830\u20133900g; mean gestational age 40.5wks, 37.9\u201342.1wks). Follow\u2010up <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> data at the age of 3\u00a0months (<jats:italic>n<\/jats:italic>=15) and over the age of 18\u00a0months (<jats:italic>n<\/jats:italic>=7) were analysed. In survivors, neurodevelopmental outcome was assessed with the Griffiths Mental Development Scales at the age of at least 18\u00a0months. Amplitude\u2010integrated electroencephalography was used to score background patterns and the occurrence of epileptiform activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> revealed abnormalities that were bilateral in all infants and symmetrical in 10. The posterior regions were more severely affected in five infants and the anterior regions in three. Watershed injury occurred in isolation in 10 out of 22 infants and was associated with involvement of the basal ganglia and thalami in the other 12, of whom seven died. Cystic evolution, seen on <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> at age 3\u00a0months, occurred in three of the 15 surviving infants. Neurodevelopmental assessment of the surviving infants was performed at a median age of 35\u00a0months (range 18\u201348mo). Of the five survivors with basal ganglia and thalamic involvement, two developed cerebral palsy, one had a developmental quotient of less than 85, and two had a normal outcome. Of the 10 infants with isolated watershed injury, nine had an early normal motor and cognitive outcome. In all infants with a favourable outcome, background recovery was seen on amplitude integrated <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> within 48\u00a0hours after birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Extensive <jats:styled-content style=\"fixed-case\">DWI<\/jats:styled-content> changes in a watershed distribution in term\u2010born neonates are not invariably associated with adverse sequelae, even in the presence of cystic evolution. Associated lesions of the basal ganglia and thalami are a better predictor of adverse sequelae than the extent and severity of the watershed abnormalities seen on <jats:styled-content style=\"fixed-case\">DW<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.12122","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T17:58:41Z","timestamp":1364839121000},"page":"642-653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Diffusion\u2010weighted imaging changes in cerebral watershed distribution following neonatal encephalopathy are not invariably associated with an adverse outcome"],"prefix":"10.1111","volume":"55","author":[{"given":"Johanna C","family":"Harteman","sequence":"first","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital University Medical Centre Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floris","family":"Groenendaal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital University Medical Centre Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona C","family":"Toet","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital University Medical Centre Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manon Jnl","family":"Benders","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital University Medical Centre Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid C","family":"Van Haastert","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children's Hospital University Medical 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