{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:24:26Z","timestamp":1788305066734,"version":"build-2803163510"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,9,1]]},"abstract":"<jats:p>OBJECTIVES. Hypoglycemia is a significant problem in neonates, and a pattern of parietooccipital diffusion restriction on MRI scans has been reported. The purpose of this study was to determine whether hypoglycemic injury, as indicated by diffusion restriction in the occipital lobes, correlated with visual evoked potentials and long-term cortical visual dysfunction.<\/jats:p>\n                  <jats:p>METHODS. A cohort of 45 neonates from 2000\u20132005 with diffusion-weighted MRI studies after hypoglycemia was studied retrospectively. Perinatal history and follow-up data were analyzed, and results were correlated with diffusion-weighted imaging findings.The presence of occipital diffusion restriction was assessed qualitatively, and the mean apparent diffusion coefficients of mesial occipital lobes were calculated.<\/jats:p>\n                  <jats:p>RESULTS. Among 25 patients who underwent diffusion-weighted imaging within 6 days after the onset of hypoglycemia, restricted diffusion in the occipital lobes was found in 8 (50%) of 16 term infants but not in preterm infants. For the remaining 20 patients, who had diffusion-weighted imaging performed &amp;gt;6 days after the initial onset of hypoglycemia, occipital diffusion restriction was not seen, even if hypoglycemia was ongoing. Restricted diffusion was associated with abnormal visual evoked potentials detected within 1 week after birth. Cortical visual deficits were seen in a significant proportion of patients with recurrent hypoglycemia and were correlated significantly with low mesial occipital apparent diffusion coefficient values.<\/jats:p>\n                  <jats:p>CONCLUSIONS. Diffusion-weighted imaging studies performed within 6 days after initial hypoglycemia were sensitive in term but not preterm neonates. Diffusion restriction, with low apparent diffusion coefficient values, in the mesial occipital poles may indicate the prognosis for visual outcomes in acute settings after neonatal hypoglycemia.<\/jats:p>","DOI":"10.1542\/peds.2007-2002","type":"journal-article","created":{"date-parts":[[2008,9,1]],"date-time":"2008-09-01T09:27:57Z","timestamp":1220261277000},"page":"507-512","source":"Crossref","is-referenced-by-count":102,"title":["Occipital Lobe Injury and Cortical Visual Outcomes After Neonatal Hypoglycemia"],"prefix":"10.1542","volume":"122","author":[{"given":"Emily W. Y.","family":"Tam","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Divisions of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elysa","family":"Widjaja","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan I.","family":"Blaser","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Division of Neuroradiology, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daune L.","family":"MacGregor","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Divisions of Neurology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Satodia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University Hospitals Coventry and Warwickshire National Health Service Trust, Coventry, England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aideen M.","family":"Moore","sequence":"additional","affiliation":[{"name":"Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,9,1]]},"reference":[{"key":"2021120905260496000_R1","doi-asserted-by":"crossref","unstructured":"Koh TH, Aynsley-Green A, Tarbit M, Eyre JA. Neural dysfunction during hypoglycaemia. Arch Dis Child.\u20081988;63(11):1353\u20131358","DOI":"10.1136\/adc.63.11.1353"},{"key":"2021120905260496000_R2","doi-asserted-by":"crossref","unstructured":"Lucas A, Morley R, Cole TH. Adverse neurodevelopmental outcome of moderate neonatal hypoglycemia. BMJ.\u20081988;297(6659):1304\u20131308","DOI":"10.1136\/bmj.297.6659.1304"},{"key":"2021120905260496000_R3","doi-asserted-by":"crossref","unstructured":"Duvanel CB, Fawer C-L, Cotting J, Hohlfeld P, Matthieu JM. Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational age preterm infants. J Pediatr.\u20081999;134(4):492\u2013498","DOI":"10.1016\/S0022-3476(99)70209-X"},{"key":"2021120905260496000_R4","doi-asserted-by":"crossref","unstructured":"Moore AM, Perlman M. Symptomatic hypoglycemia in otherwise healthy, breast-fed term newborns. Pediatrics.\u20081999;103(4):837\u2013839","DOI":"10.1542\/peds.103.4.837"},{"key":"2021120905260496000_R5","doi-asserted-by":"crossref","unstructured":"Cornblath M, Hawdon JM, Williams AF, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics.\u20082000;105(5):1141\u20131145","DOI":"10.1542\/peds.105.5.1141"},{"key":"2021120905260496000_R6","unstructured":"Spar HA, Lewine JD, Orrison WW. Neonatal hypoglycemia: CT and MR findings. AJNR Am J Neuroradiol.\u20081994;15(8):1477\u20131478"},{"key":"2021120905260496000_R7","unstructured":"Barkovich AJ, Al Ali F, Rowley HA, Bass N. Imaging patterns of neonatal hypoglycemia. AJNR Am J Neuroradiol.\u20081998;19(3):523\u2013528"},{"key":"2021120905260496000_R8","doi-asserted-by":"crossref","unstructured":"Traill Z, Squier M, Anslow P. Brain imaging in neonatal hypoglycemia. Arch Dis Child Fetal Neonatal Ed.\u20081998;79(2):F145\u2013F147","DOI":"10.1136\/fn.79.2.F145"},{"key":"2021120905260496000_R9","doi-asserted-by":"crossref","unstructured":"Alkalay AL, Flores-Sarnat L, Sarnat HB, Moser FG, Simmons CF. Brain imaging findings in neonatal hypoglycemia: case report and review of 23 cases. Clin Pediatr (Phila).\u20082005;44(9):783\u2013790","DOI":"10.1177\/000992280504400906"},{"key":"2021120905260496000_R10","doi-asserted-by":"crossref","unstructured":"Kinnala A, Rikalainen H, Lapinleinu H, et al. Cerebral magnetic resonance imaging and ultrasonography findings after neonatal hypoglycemia. Pediatrics.\u20081999;103(4):724\u2013729","DOI":"10.1542\/peds.103.4.724"},{"key":"2021120905260496000_R11","doi-asserted-by":"crossref","unstructured":"Kim SY, Goo HW, Lim KH, Kim ST, Kim KS. Neonatal hypoglycaemic encephalopathy: diffusion-weighted imaging and proton MR spectroscopy. Pediatr Radiol.\u20082006;36(2):144\u2013148","DOI":"10.1007\/s00247-005-0020-2"},{"key":"2021120905260496000_R12","doi-asserted-by":"crossref","unstructured":"Filan PM, Inder TE, Cameron FJ, Kean MJ, Hunt RW. Neonatal hypglycaemia and occipital cerebral injury. J Pediatr.\u20082006;148(4):552\u2013555","DOI":"10.1016\/j.jpeds.2005.11.015"},{"key":"2021120905260496000_R13","doi-asserted-by":"crossref","unstructured":"Hankins GDV, Speer M. Defining the pathogenesis and pathophysiology of neonatal encephalopathy and cerebral palsy. Obstet Gynecol.\u20082003;102(3):628\u2013636","DOI":"10.1097\/00006250-200309000-00036"},{"key":"2021120905260496000_R14","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists. Neonatal encephalopathy and cerebral palsy: executive summary. Obstet Gynecol.\u20082004;103(4):780\u2013781","DOI":"10.1097\/01.AOG.0000120142.83093.30"},{"key":"2021120905260496000_R15","unstructured":"Volpe JJ. Hypoglycemia and brain injury. In: Volpe JJ, ed. Neurology of the Newborn. 4th ed. Philadelphia, PA: Saunders;2001:497\u2013520"},{"key":"2021120905260496000_R16","doi-asserted-by":"crossref","unstructured":"Boichot C, Walker PM, Durand C, et al. Term neonate prognoses after perinatal asphyxia: contributions of MR imaging, MR spectroscopy, relaxation times, and apparent diffusion coefficients. Radiology.\u20082006;239(3):839\u2013848","DOI":"10.1148\/radiol.2393050027"},{"key":"2021120905260496000_R17","doi-asserted-by":"crossref","unstructured":"Ku\u0308ker W, Mo\u0308hrle S, Mader I, Scho\u0308ning M, Na\u0308gele T. MRI for the management of neonatal cerebral infarctions: importance of timing. Childs Nerv Syst.\u20082004;20(10):742\u2013748","DOI":"10.1007\/s00381-004-0988-1"},{"key":"2021120905260496000_R18","doi-asserted-by":"crossref","unstructured":"Salhab WA, Wyckoff MH, Laptook AR, Perlman JM. Initial hypoglycemia and neonatal brain injury in term infants with severe fetal acidemia. Pediatrics.\u20082004;114(2):361\u2013366","DOI":"10.1542\/peds.114.2.361"},{"key":"2021120905260496000_R19","doi-asserted-by":"crossref","unstructured":"Miralles RE, Lodha A, Perlman M, Moore AM. Experience with intravenous glucagon infusions as a treatment for resistant neonatal hypoglycemia. Arch Pediatr Adolesc Med.\u20082002;156(10):999\u20131004","DOI":"10.1001\/archpedi.156.10.999"},{"key":"2021120905260496000_R20","doi-asserted-by":"crossref","unstructured":"Powers WJ, Rosenbaum JL, Dence CS, Markham J, Videen TO. Cerebral glucose transport and metabolism in preterm human infants. J Cereb Blood Flow Metab.\u20081998;18(6):632\u2013638","DOI":"10.1097\/00004647-199806000-00005"},{"key":"2021120905260496000_R21","doi-asserted-by":"crossref","unstructured":"Chugani HT, Phelps ME. Maturational changes in cerebral function in infants determined by 18FDG positron emission tomography. Science.\u20081986;231(4740):840\u2013843","DOI":"10.1126\/science.3945811"},{"key":"2021120905260496000_R22","doi-asserted-by":"crossref","unstructured":"Chugani HT. Positron emission tomography study of human brain functional development. Ann Neurol.\u20081987;22(4):487\u2013497","DOI":"10.1002\/ana.410220408"},{"key":"2021120905260496000_R23","doi-asserted-by":"crossref","unstructured":"Skov L, Pryds O. Capillary recruitment for preservation of cerebral glucose influx in hypoglycemic, preterm newborns: evidence for a glucose sensor?Pediatrics.\u20081992;90(2):193\u2013195","DOI":"10.1542\/peds.90.2.193"},{"key":"2021120905260496000_R24","doi-asserted-by":"crossref","unstructured":"Koivisto M, Blanco SM, Krause U. Neonatal symptomatic and asymptomatic hypoglycemia: a follow-up study of 151 children. Dev Med Child Neurol.\u20081972;14(5):603\u2013614","DOI":"10.1111\/j.1469-8749.1972.tb02642.x"},{"key":"2021120905260496000_R25","unstructured":"Pildes RS, Cornblath M, Warren I. A prospective controlled study of neonatal hypoglycemia. Pediatrics.\u20081974;54(1):5\u201314"},{"key":"2021120905260496000_R26","doi-asserted-by":"crossref","unstructured":"Caraballo RH, Sakr D, Mozzi M, et al. Symptomatic occipital lobe epilepsy following neonatal hypoglycemia. Pediatr Neurol.\u20082004;31(1):24\u201329","DOI":"10.1016\/j.pediatrneurol.2003.12.008"},{"key":"2021120905260496000_R27","doi-asserted-by":"crossref","unstructured":"Miller SP, Vigneron DB, Henry RG, et al. Serial quantitative diffusion tensor MRI of the premature brain: development in newborns with and without injury. J Magn Reson Imaging.\u20082002;16(6):621\u2013632","DOI":"10.1002\/jmri.10205"},{"key":"2021120905260496000_R28","doi-asserted-by":"crossref","unstructured":"Fahnehjelm KT, Jacobson L, Hellstrom A, Lewensohn-Fuchs I, Ygge J. Visually impaired children with posterior ocular malformations: pre- and neonatal data and visual functions. Acta Ophthalmol Scand.\u20082003;81(4):361\u2013372","DOI":"10.1034\/j.1600-0420.2003.00100.x"},{"key":"2021120905260496000_R29","doi-asserted-by":"crossref","unstructured":"Burns CM, Rutherford MA, Boardman JP, Cowan FM. Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics\u20082008;122(1):65\u201374","DOI":"10.1542\/peds.2007-2822"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/3\/507\/1175690\/zpe00908000507.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/3\/507\/1175690\/zpe00908000507.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T16:28:52Z","timestamp":1684513732000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/122\/3\/507\/72301\/Occipital-Lobe-Injury-and-Cortical-Visual-Outcomes"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9,1]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2008,9,1]]},"published-print":{"date-parts":[[2008,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2007-2002","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,9,1]]}}}