This monograph explores the mechanisms and timing of possible etiologic events that contribute to fetal and neonatal neurologic injury. the report presents evidence that most cases of cerebral palsy are a result of multifactorial and unpreventable causes that occur during fetal development or in the newborn after delivery, and not a result of an isolated intrapartum hypoxic event. the report contains a set of criteria that may be used to define (or rule out) an acute intrapartum hypoxic event sufficient to cause or suggest cerebral palsy.

Significantly revised and updated, the new second edition updates the science on neonatal encephalopathy presented in the 1st edition. The new 2nd edition recommends a broad evaluation of all potential contributing factors in every case of neonatal encephalopathy, including maternal medical history, obstetric and intrapartum factors, and placental pathology. This recommendation is a shift from the 2003 report, which focused on determining whether or not a hypoxic-ischemic event was the cause of neonatal encephalopathy. Includes new sections on - Placental pathology - Focal ischemic stroke - Neonatal interventions - Patient safety - Significant advances in neuroimaging This report will assist the clinician in evaluating a newborn with encephalopathy to assist in defining both the cause and timing.

Cerebral palsy (CP), defined as a group of nonprogressive disorders of movement and posture, is the most common cause of severe neurodisability in children. Understanding its physiopathology is crucial to developing some protective strategies. Interruption of oxygen supply to the fetus or brain asphyxia was classically considered to be the main causal factor explaining later CP. However several ante-, peri-, and postnatal factors could be involved in the origins of CP syndromes. Congenital malformations are rarely identified. CP is most often the result of environmental factors, which might interact with genetic vulnerabilities, and could be severe enough to cause the destructive injuries visible with standard imaging (i.e., ultrasonographic study or MRI), predominantly in the white matter in preterm infants and in the gray matter and the brainstem nuclei in full-term newborns. Moreover they act on an immature brain and could alter the remarkable series of developmental events. Biochemical key factors originating in cell death or cell process loss, observed in hypoxic−ischemic as well as inflammatory conditions, are excessive production of proinflammatory cytokines, oxidative stress, maternal growth factor deprivation, extracellular matrix modifications, and excessive release of glutamate, triggering the excitotoxic cascade. Only two strategies have succeeded in decreasing CP in 2-year-old children: hypothermia in full-term newborns with moderate neonatal encephalopathy and administration of magnesium sulfate to mothers in preterm labor.

The Guest Editors have assembled top experts to provide the most current and clinically relevant articles devoted to Birth Asyphyxia. Articles in this issue are devoted to: Neonatal Transition After Birth; Pathophysiology of Birth Asphyxia; Perinatal Asphyxia from the Obstetrical Standpoint: Diagnosis and Interventions; Stillbirths: U.S. and Global Perspectives; Novel Approaches to Resuscitation and the Impact on Birth Asphyxia; Multiorgan Dysfunction and its Management After Birth Asphyxia; Neonatal Encephalopathy and Update on Therapeutic Hypothermia and Other Novel Therapeutics; Biomarkers in Neonatal Encephalopathy; Imaging and Other Diagnostics in Neonatal Encephalopathy; Asphyxia in the Premature Infant; The role of the NeoNeuro Unit for Birth Asphyxia; Long-term Cognitive Outcomes of Birth Asphyxia and the Contribution of Identified Perinatal Asphyxia to Cerebral Palsy; Global Burden, Epidemiologic Trends, and Prevention of Intrapartum Related Deaths in Low-resource Settings; and Neonatal Resuscitation in Low-resource Settings.

Development of the brain and the emergence of the mind constitute some of the most important concerns of contemporary biology. Disturbances during fetal life may have profound implications for a child's future neurological and psychological development, which can in turn impact society. The new edition of this highly respected work presents a comprehensive review of the basic mechanisms of brain development and the pathophysiology of disorders of the infant brain, written by a team of distinguished neuroscientists, neonatologists, and neuropediatricians. The book follows the main milestones of brain development, from formation of the neural tube and wiring of the neurons in the brain. Neurotrophic factors, neurotransmitters, glial cell biology, cerebral circulation development of sensory functions are all described in detail. Furthermore, there are more philosophical chapters on the evolution of the brain and the emergence of consciousness. Clinical considerations are highlighted where relevant.

The aim of this Research Topic was to collate articles describing prediction of outcomes of pre- and perinatal lesions leading to cerebral palsy, basic research in animal models and human subjects, and ideas for, and trials of, interventions in the first two years of life. CP arises from insults to the sensorimotor cortex, subcortical axon tracts and subplate. The aetiology is complex and often multifactorial. The outcome is not simply a loss of voluntary control due to disruption of descending pathways, but also involves abnormal development of reflex and corticospinal circuitry. CP may be viewed as aberrant plasticity in response to a lesion, indeed, abnormalities in movement are subtle at first but develop subsequently. It is misleading to suppose that developmental mechanisms are self-reparative. The challenge is to understand activitydependent fine tuning of neural circuitry during normal development and to find how to promote desirable plasticity whilst limiting undesirable effects following developmental lesions. However, before proposing interventions, we have to develop our ability to predict the severity of neonatal insults. We solicited a variety of articles, including long and short reviews, original research and opinion pieces, from both basic scientists and clinicians. Likewise we, as editors, have complementary knowledge and experience in this area. Anna Basu is an academic pediatric neurologist and Gavin Clowry is a developmental neuroscientist.