Understanding Hypoxic Ischemic Encephalopathy Injuries

Hypoxic ischemic encephalopathy (HIE) is a devastating birth injury; if your child has been diagnosed, you are no doubt wondering what the future holds for them, and how you can help them live the best and fullest life possible. In this blog post, we’ll discuss what HIE is, what complications it can cause, and what you can do for your child.

What is Hypoxic Ischemic Encephalopathy?

The best way to understand hypoxic ischemic encephalopathy is to break the phrase down:

• Hypoxic: refers to a lack of adequate oxygen to the body’s tissues, including the brain.

• Ischemic: refers to restricted blood flow; in this context, it means restricted blood flow to the brain, which limits oxygen and nutrients the brain needs to function.

• Encephalopathy: “Encephalo-” refers to the brain; “-pathy” is a suffix that refers to disease. In short, “encephalopathy” means “brain disease or dysfunction.”

Putting the words all together, hypoxic ischemic encephalopathy is a brain disorder caused by restricted blood flow to the brain, and the lack of oxygen that results.

What Causes HIE?

HIE may be due to conditions that arise before, during, or after the birth process. These include:

• Maternal infections like chorioamnionitis
• Preeclampsia or eclampsia
• Placental abruption
• Diabetes, anemia, or other maternal health conditions that limit delivery of oxygen to the fetus
• Intrauterine growth restriction in the fetus
• Congenital heart defects
• Problems with the placenta (placental insufficiency, placenta previa)
• Complications with the umbilical cord, such as prolapse or compression
• Difficult or prolonged labor
• Uterine rupture
• Meconium aspiration after birth
• Sepsis

Medical providers should be alert to these and any other conditions that could cause HIE. Because treatment is most effective as soon as possible after the oxygen deprivation, failure to appropriately monitor for and treat hypoxic ischemic encephalopathy may constitute medical malpractice.

Categories of Hypoxic Ischemic Encephalopathy Birth Injury

Hypoxic ischemic encephalopathy injury is usually categorized as mild, moderate or severe. Symptoms are typically apparent within hours to days after birth. Mild cases may manifest as irritability in the newborn, some difficulty feeding, or muscle tone abnormalities that are temporary. Infants with mild HIE injuries often recover fully within a few days after birth.

With moderate HIE birth injuries, a newborn may exhibit lethargy or reduced activity, significant difficulty feeding, and muscle tone issues in the mild-to-moderate range. There may be problems with reflexes or coordination, and in some cases, seizures. Therapeutic hypothermia, also known as cooling therapy, may be administered, to protect the brain and minimize the effects of the injury.

Severe HIE birth injuries may be evident immediately after birth; the newborn may be unresponsive, breathing abnormally, and be either unusually stiff or floppy, indicating serious muscle tone abnormalities. The baby may also have seizures that are frequent and/or hard to get under control. Unfortunately, severe HIE can lead to permanent and severe brain damage or death if not promptly treated.

Possible Complications from HIE Brain injury

One common complication of hypoxic ischemic encephalopathy is cerebral palsy. There are various types of cerebral palsy (CP), but the one most frequently seen in HIE brain injuries is spastic cerebral palsy. Children with spastic CP often have difficulty with balance, movement, and coordination. They may have muscles that are stiff and tight, and experience exaggerated reflexes.

Spastic cerebral palsy may affect primarily the legs (spastic diplegia), one side of the body, (spastic hemiplegia), or all four limbs and the torso (spastic quadriplegia). In spastic quadriplegia, a child may also have ongoing seizures and intellectual disabilities.

Whether or not a child has cerebral palsy, he or she may develop other complications from HIE, including:

• Cognitive impairments such as learning disabilities, severe intellectual disabilities, and attention deficit disorder. Children with a history of HIE frequently struggle with processing information, memory, and problem-solving. In more severe cases, there may be significant developmental delays.
• Motor skill challenges. Children with HIE brain injuries may have problems with fine motor skills, making it more challenging to use utensils, write, and even button their clothing. Gross motor difficulties are also common even in the absence of CP, leading to problems walking, running, and balancing. Balance issues and poor coordination can also make it difficult to ride a bicycle or catch a ball.
• Sensory problems such as hearing impairment and visual impairment, and sensory processing disorders, such as atypical responses to light, sound, or touch.
• Emotional and behavioral challenges are also common in children who have experienced HIE. These children often struggle to regulate their emotions and to interpret social cues, leading to temper tantrums and meltdowns. They may be impulsive and exhibit behavior that looks like ADHD or autism.

The list above may be discouraging, especially if your child is still a baby and you fear the worst. It’s difficult to predict what the future holds, but there is reason for hope. In order to provide your child with the therapies, aids, and ongoing care needed to live their best life, you will need resources. If your child’s HIE birth injuries were due to medical malpractice, or worsened by medical malpractice, filing a claim may be critical to getting them the help they need.

Work with an Experienced Medical Malpractice Attorney

It’s natural to want to focus on your child at this time, and pursuing a medical malpractice claim may not feel like a priority. However, you only have a limited time in which to file a claim, and doing so is the best way to provide your child with the resources they will need. It’s important for your child’s future that you act quickly. To learn more about hypoxic ischemic encephalopathy or medical malpractice, contact The Fraser Firm to schedule a consultation.