Clinical Characteristics and Prognostic Analysis of Term Infants with Encephalomalacia of Different Etiologies
ZHANG Xinling
SONG Juan
YANG Luxiang
MIAO Jingwen
Abstract：Objective To analyze the perinatal characteristics,imaging features,and long-term neurological prognosis of full-term infants with encephalomalacia caused by different etiologies.Methods A retrospective analysis was conducted on full-term infants diagnosed with encephalomalacia by cranial MRI at the Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,from January 2015 to June 2022.Perinatal data and cranial MRI images were collected.Follow-up records after discharge and neurological developmental assessments were obtained,with a focus on infants followed up until they were over 2 years old to evaluate their neurological prognosis.Results(1)Basic information:a total of 143 full-term infants with encephalomalacia were included in the study.The average age at imaging diagnosis of encephalomalacia was(1.7±0.4)months.Of these,15 cases were lost to follow-up,and 1 died,leaving 127 cases for final analysis.The male-to-female ratio was 2.34∶1,with an average follow-up age of(3.4±2.5)years.The incidence of neurological developmental disorders was 92.9％(118/127).Among them,the incidence of cerebral palsy was 53.5％(68/127),epilepsy was 63.0％(80/127),cognitive impairment was 62.2％(79/127),and visual impairment occurred in 8.7％(11/127)of the infants.(2)Etiology analysis:the main causes of encephalomalacia in term infants,in descending order of frequency,were neonatal hypoxic-ischemic encephalopathy(39.4％,50/127),symptomatic hypoglycemia(26.8％,34/127),intraparenchymal hemorrhage(21.3％,27/127),intracranial infection(3.9％,5/127),and neonatal arterial ischemic stroke(3.1％,4/127).(3)Imaging features:encephalomalacia caused by symptomatic hypoglycemia primarily affects the occipital lobe(88.2％,30/34,P＜0.001),with most cases being bilateral(91.2％,31/34,P＜0.001).In contrast,encephalomalacia caused by neonatal arterial ischemic stroke was more commonly observed in the basal ganglia(50.0％,2/4,P＜0.05),and typically involves unilateral involvement(100.0％,4/4,P＜0.001).(4)Neurological prognosis:the epilepsy incidence was highest in the symptomatic hypoglycemia group(91.2％,31/34,P＜0.001).The incidence of spastic quadriplegia was higher in the neonatal hypoxic-ischemic encephalopathy group(47.2％,17/36)and the intracranial infection group(75.0％,3/4)(P＜0.05),while spastic hemiplegia was more common in the intraparenchymal hemorrhage group(76.5％,13/17)and the neonatal arterial ischemic stroke group(100.0％,4/4)(P＜0.001).The incidence of cerebral palsy alone was highest in the neonatal arterial ischemic stroke group(100.0％,4/4,P＜0.001).In contrast,the combination of cerebral palsy,epilepsy,and cognitive impairment was most prevalent in the intracranial infection group,with an incidence of 80.0％(4/5,P＜0.001).Conclusion The primary causes of encephalomalacia in full-term infants are neonatal hypoxic-ischemic encephalopathy,symptomatic hypoglycemia,intraparenchymal hemorrhage,neonatal arterial ischemic stroke,and intracranial infection.The affected brain regions vary according to the etiology,and long-term neurological developmental disorders is high.
Keywords：encephalomalaciafull-term infantsclinical featuresimagingneurodevelopmental prognosis
Publication Date：2025-09-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 3287-3293 )