A group of Stanford researchers has improved on a technique that diagnoses mini-strokes in babies. Mini-strokes are fairly common for infants born prematurely and can occur in full-term infants as well. Doctors rely on ultrasounds to identify injuries to babies’ brains; however, old techniques using these scans don’t always provide enough information for doctors to give accurate prognoses. New research has increased the capacity of ultrasounds to show an infant’s brain structure. Scans can now provide real-time insights into brain function. It is believed that this new technology will help doctors identify the consequences of brain bleeds in infants.
In general, a baby’s body is capable of responding well to injuries, especially injuries to the head. Infant’s brains have high plasticity, meaning that when one part of the brain is injured, other parts take over those functions. High plasticity is ideal because it helps infants adapt to brain injuries in a way that allows them to function well. However, this can also obscure the damage done, hindering doctors’ ability to identify potential long-term effects.
The New Technology Explained
The new technique begins with creating a detailed map of brain activity in healthy babies to use as a baseline. Doctors can compare the brains of infants who suffered from mini-strokes against the brains of those who did not. The new technique can be accomplished with existing ultrasound machines; therefore, patients shouldn’t see a huge increase in costs.
Ultrasounds map brain activity by projecting high-frequency sound waves into the body and detecting the way the sound waves are returned to the machine. The machine translates the signals into a picture that doctors can read. Sound waves don’t penetrate bone; however, babies’ skulls aren’t fully formed, allowing the emitter to be placed between the bones. The ultrasound detects the movement of blood, which is linked to neural activity.
The new technique refines how the ultrasound machine translates the activity. The machine ordinarily picks up background information, such as the infant’s movements and the motion from the doctor’s hand. The new technique is better at filtering out this background noise to create more accurate pictures. It is believed that this will spur new research on how to deal with brain bleeds and their consequences.
Understanding Brain Bleeds
Brain bleeds occur at higher rates than are ideal. Brain bleeds can range from small issues that require no treatment to severe bleeding that results in compression on the brain or tissue damage. More severe bleeds may require immediate medical intervention. Understanding the causes and treatments can help parents and patients in dealing with brain bleeds.
Brain bleeds are defined differently depending on cause and location. Three common terms for brain bleeds are (1) intracranial hemorrhage, (2) intraventricular hemorrhage, and (3) subarachnoid hemorrhage. Intracranial hemorrhage occurs between the brain and the skull, or when there is bleeding anywhere inside the brain. Intraventricular hemorrhage refers to when there is excess blood flow into the ventricles of the brain, the tubes that connect the brain to the spine and allow it to communicate with the rest of the body. Finally, subarachnoid hemorrhage refers to bleeding between the brain and the membrane that surrounds the brain.
Causes and Symptoms of Brain Bleeds
Brain bleeds are caused by several events that occur during, before, or after birth. The most common causes of brain bleeds are head injuries that occur during birth, blood disorders, and blood vessel abnormalities. Head and brain injuries are common during birth as the infant must contort to extreme measures to fit through the birth canal. Injuries caused by tools used by physicians during birth are also common. Blood vessel abnormalities can include weakened vessels, aneurysms, or malformed vessels.
Some common symptoms of brain bleeds include:
- Stiff neck
- Trouble with vision, movement, or speech
- Changes in mood or personality
Many of these symptoms are hard to diagnose in an infant, underscoring the importance of developing better diagnostic techniques through research.
Diagnosing and Treating Brain Bleeds
In addition to new diagnostic techniques, doctors also have several other new tools at their disposal to diagnose and treat brain bleeds in an infant. Doctors can conduct a transcranial doppler test. This test is similar to an ultrasound and uses sound waves to measure blood flow. The test is non-invasive. Physicians can also conduct an angiography, which is when a thin tube is inserted into the blood vessels going into the brain and injected with a dye. This allows the doctors to photograph the brain and watch the movement of the dye, allowing them to clearly monitor blood flow. Finally, doctors can conduct an MRI/CT scan, which provides a picture of how the infant’s brain is working.