Neurology · UKMLA & AKT
Hypoxic-ischaemic encephalopathy
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hypoxic-ischaemic encephalopathy — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Serious neonatal neurological condition caused by insufficient oxygen delivery to the brain around the time of birth (perinatal asphyxia)
- Affects ~1-3 per 1000 live term births; predominantly term or near-term neonates
- Two-phase injury model - understanding this explains why the 6-hour treatment window exists:
- Phase 1 (primary energy failure): hypoxia → ATP depletion → Na+/K+ ATPase failure → cytotoxic oedema → glutamate release → calcium influx → neuronal death
- Latent phase (1-6 hours): apparent partial recovery - this is the critical therapeutic window
- Phase 2 (secondary energy failure, 6-72 hours): delayed inflammation, excitotoxicity, free radical production, apoptosis - causes the majority of long-term damage
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