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PEDIATRICS Vol. 114 No. 1 July 2004, pp. 291-294

EXPERIENCE AND REASON

Cerebral Metabolism in Severe Neonatal Hyperbilirubinemia

Floris Groenendaal, MD, PhD*, Jeroen van der Grond, PhD{ddagger} and Linda S. de Vries, MD, PhD*

* Departments of Neonatology
{ddagger} Radiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands

The metabolism of the basal ganglia was examined by using proton magnetic resonance spectroscopy in 5 neonates with severe hyperbilirubinemia. A decreased N-acetylaspartate/choline ratio, indicating neuronal injury, and an abnormally high lactate/N-acetylaspartate ratio were found only in the neonate with neonatal magnetic resonance imaging abnormalities and subsequent cerebral palsy.

Key Words: bilirubin • neonate • kernicterus • magnetic resonance spectroscopy • metabolism

Abbreviations: MRI, magnetic resonance imaging • 1H-MRS, proton magnetic resonance spectroscopy • NAA, N-acetylaspartate • Cho, choline • ABR, auditory brainstem response • AABR, automated auditory brainstem response • ADC, apparent diffusion coefficient • G6PD, glucose-6-phosphate dehydrogenase

Received for publication Sep 2, 2003; Accepted Mar 3, 2004.