MRI Brain Changes in Neonatal Hypoglyceamia in a Rural Tertiary Care Centre

Introduction : Approximately half of a newborn baby's energy needs are fulfilled by glucose during birth, and glucose is an essential fuel for brain metabolism. The purpose of this study is to evaluate the neuroimaging characteristics of hypoglycaemia in neonates using MRI. Methods: A prospective observational study was conducted among 30 neonates who were enrolled in the study after taking informed written consent from parents or attendant accompanying the neonate in the Department of Paediatrics of SHKM GMC, Nalhar, Nuh. All babies with hypoglyceamia underwent MRI brain when they were stabilized at discharge. All babies’ MRI changes were recorded. Results: In our study Neonatal Hypoglycaemia was found more commonly in 34-37 weeks of gestational age(50%), specially in appropriate for gestational age babies(90%) compared to term babies. Majority of the cases were Male(63.3%) with majority of normal vaginal mode of delivery with Birth weight between 1.5-2.5 kg in most cases(63.3%).Maximum patients had Lower Blood Glucose level between 20-40 mg/dl (80%), with sepsis with meningitis(30%) as most common cause of hypoglycaemia. In our study Lowest blood glucose level observed was 11 mg/dl which was associated with abnormal MRI Brain change (Focal hemorrhagic lesions over parietal and occipital regions).Most common abnormal MRI Brain change were observed in parietooccipital region with Sepsis with meningitis as most common cause of hypoglyceamia in these patientsSepsis was present in most cases with abnormal MRI findings (10 cases) among which 9 cases were positive for Meningits , 2 of them had proven sepsis (Acinetobacter species).1 patient was found to have prolonged hypoglyceamia who received GIR above 12 and steroids, associated with abnormal MRI finding Periventricular Leukomalacia. Conclusion: This study had shown that, MRI results suggested aberrant hyperintensity in regions of brain. The lesions ranged from hyperintensity, signal intensity and hemorrhages across the parietal and occipital regions.