Hypoxic-Ischemic Encephalopathy HIE Brain Injury

Oxygen and glucose provide fuel for the brain. This is supplied by the blood pumping through the body, carrying oxygen to the brain so that the brain and nervous system can function properly. Even a temporary restriction in blood supply or oxygen to the brain can begin to cause impairment. 

An extended lack of oxygen can cause permanent brain damage. The longer the brain goes without oxygen, the more extensive the damage to the brain can be. Even a few minutes without oxygen can cause permanent damage. 

Lack of oxygen is often the cause of brain injury for infants and newborns. This can leave children suffering developmental injuries and physical disabilities for the rest of their lives. It may be even more painful for parents to learn that the brain injury was preventable. 

What is Hypoxic-Ischemic Encephalopathy?

Hypoxic-ischemic encephalopathy (HIE) is a brain injury caused by oxygen deprivation due to hypoxic or anoxic injuries. Hypoxia involves reduced blood oxygenation to the brain. Ischemia is diminished blood flow to the brain. 

Anoxia and hypoxia are related conditions. Anoxic brain injury is damage caused by a total lack of oxygen supply. Hypoxic brain injury is an injury caused by a reduction of oxygen supply. Hypoxic ischemia is a partial lack of oxygen to the brain combined with a decrease in blood flow to the brain, which can lead to brain damage. 

Hypoxic-ischemic encephalopathy can involve a number of causes, from traumatic accidents to drug overdose to shock. The cause of HIE is generally different for adults compared to newborns, who are more likely to suffer anoxia in the womb or during labor. For adults, HIE may be caused by a cardiac arrest or traumatic brain injury, with secondary hypoxia following the ischemic event. 

When blood flow and oxygen to the brain is reduced, the body may compensate by prioritizing blood flow to the brain and other vital organs. If the brain continues to lack oxygen, early onset of symptoms may begin with memory problems and difficulty in learning tasks. Continued oxygen deprivation can cause:

  • Decrease in motor control, 
  • Cognitive dysfunction, 
  • Cyanosis of the skin, 
  • Increased heart rate,
  • Loss of consciousness, 
  • Coma, 
  • Seizures, and 
  • Brain death.

Causes of Hypoxic-Ischemic Brain Injury in Infants

Hypoxic brain injury can be more harmful to a fetus, newborn, or infant because of their developing brains. Children may also be more difficult to evaluate for brain injuries and brain damage may only become evident as the child develops. A parent may not even learn of their child's injury until years later. 

Anoxia and hypoxia are common causes for birth injuries, where the child has their oxygen supply cut off for a period of time. Lack of oxygen at birth can lead to developmental delays, brain damage, and death. Common causes of lack of oxygen for birth injuries include: 

  • Nuchal umbilical cord (wrapped around the neck)
  • Prolapsed cord
  • Acute maternal hypotension
  • Traumatic birth
  • Uterine rupture
  • Preeclampsia
  • Placenta previa
  • Anesthesia errors
  • Premature birth
  • Delayed C-section

Signs and symptoms of a newborn suffering HIE can occur during pregnancy, during labor, or in the neonatal or infant stages, including: 

  • Decreased fetal movement
  • Severe maternal cramping and back pain
  • Abnormal fetal heart rate
  • Abnormal contractions
  • Abnormally low or high maternal weight gain
  • Maternal high blood pressure
  • Vaginal bleeding
  • Low Apgar scores
  • Seizures
  • Difficulty feeding
  • Breathing problems
  • Low muscle tone
  • Organ failure or organ damage
  • Abnormal response to light
  • Hyperalert or lethargic
  • Coma
  • Seizures
  • Impaired motor function
  • Delayed developmental milestones
  • Delayed growth
  • Hearing or visual impairments

Some of these medical conditions caused by a lack of oxygen include cerebral palsy, epilepsy, developmental delays, neurodevelopmental delays, cognitive impairment, language impairment, coordination problems, and motor impairment. Unfortunately for parents, the extent of the impairment may not become known until the child reaches the age of 3 to 4.

It is important for parents and doctors to watch for signs and symptoms of HIE throughout the pregnancy and early development. Early identification and intervention can be important for treatment and recovery, and reduce the risk of permanent brain damage. Brain injury caused by HIE or other lack of oxygen injuries may be preventable. If an injury was caused by a doctor's failure to properly treat or monitor the mother and baby, the family may have a birth injury malpractice claim. 

Treatment of HIE Brain Injury and Prognosis

One of the ways that doctors can diagnose hypoxic ischemic injury is through imaging. There may be a number of imaging options and multiple images may be taken to evaluate the patient, including: 

  • Magnetic resonance imaging (MRI)
  • Ultrasonography (US)
  • Computed tomography (CT)
  • Echocardiography, 
  • Electroencephalography. 

Other diagnostic lab tests can show abnormal blood results which could indicate an ischemic event. 

After a child has suffered an HIE brain injury, the treatment options may be limited and the family may have to focus on raising a child with a brain injury and developmental delays. The costs and care associated with raising a child after a brain injury are likely to continue for the rest of the child's life. Treatment may include: 

  • Medication
  • Visits to doctors and specialists
  • Physical therapy
  • Behavioral therapy
  • Special education expenses
  • In-home care specialists
  • Medical equipment
  • Home modifications

When the brain injury was caused by negligence, medical mistakes, or medical errors, the healthcare professionals responsible should be held accountable for their actions. It can cost a family millions of dollars in care and medical expenses to raise a child with a brain injury and the negligent parties should cover the costs. 

A medical malpractice lawsuit can help the family recover damages associated with the birth injuries. Damages in a medical malpractice lawsuit can include: 

  • Medical expenses
  • Future medical care
  • Loss of enjoyment of life
  • Pain and suffering
  • Loss of companionship
  • Loss of earning capacity

Hypoxic-Ischemic Encephalopathy Brain Injury Attorneys

If your child suffered a hypoxic-ischemic brain injury, it may have been caused by the failure of the medical system to provide proper care. If a medical mistake caused developmental delays for your child, talk to an experienced medical malpractice attorney about holding the doctors and hospitals accountable for their negligence. Do not hesitate to contact Gilman & Bedigian today for a free consultation.

Let Us Help

If someone you are close to has been seriously injured or worse, you are naturally devastated not only by what has happened, but by the effect that the injury or loss has had on you and your family. At a time when you're vulnerable, traumatized and emotionally exhausted, you need a team that will support you through the often complex process that lies ahead.