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PEDIATRIC ANESTHESIOLOGY

Neuroprotective Strategies for the Neonatal Brain

Vincent Degos, MD^*, Gauthier Loron, MD^*, Jean Mantz, MD, PhD^*, and Pierre Gressens, MD, PhD^*

From the *Inserm, U676, Paris, France; Université Paris 7, Faculté de Médecine Denis Diderot, IFR02 and IFR25, Paris, France; AP HP, Hôpital Beaujon, Département d’Anesthésie Réanimation, Clichy, France; and AP HP, Hôpital Robert Debré, Service de Neurologie Pédiatrique, Paris, France.

Address correspondence and reprint requests to Pierre Gressens, MD, PhD, Inserm U676, Hôpital Robert Debré, 48 Bvd Sérrurier, 75019 Paris, France. Address e-mail to pierre.gressens{at}inserm.fr.

Abstract

Injury to the perinatal brain is a leading cause of childhood mortality and lifelong disability. Cerebral palsy and cognitive impairment are usually related to periventricular white matter damage, which is seen chiefly in babies born before 32 wk gestational age, and to corticosubcortical lesions, which occur mainly in full-term infants. Despite recent improvements in neonatal care, no effective treatment for perinatal brain lesions is available. Several interventions, such as magnesium sulfate in preterm newborns and hypothermia in term newborns, are the focus of completed or continuing clinical trials. Improved understanding of the pathophysiological mechanisms involved in perinatal brain lesions helps to identify potential targets for neuroprotective interventions, as discussed in this review.

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