Neurology · UKMLA & AKT
Hypoxic-ischaemic encephalopathy
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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