Despite therapeutic hypothermia, some survivors of neonatal encephalopathy (NE) still have adverse outcomes. Surrogate outcome measures or biomarkers are needed for early detection of babies with adverse outcome so that adjunct therapies can be considered. Basal ganglia and thalamus (BGT) lactate/ N-Acetyl-Aspartate (Lac/NAA) peak area ratio acquired with proton magnetic resonance spectroscopy (MRS) is a reliable predictor of developmental outcome at two years. Cerebral blood flow (CBF) changes in parallel with the metabolic changes after hypoxia ischaemia (HI). We hypothesised that the combination of CBF with BGT Lac/NAA would be more closely associated with quantitative cell death than either alone.
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