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Hypoxic Ischemic Encephalopathy and Brain growth
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Hypoxic Ischemic Encephalopathy and Brain growth

My daughter is five months old and seems to be developmentally reaching her milestones. The neurologist tells me that she is surprised that she is doing so well. The worry I have is that the MRI does show brain damage and the report specifically says there is severe generalized atrophy and cystic encephalomalacia of both cerebral hemispheres but the basal ganglia, brainstem, and cerebellum appear normal. I think because of this my daughters head is not growing as fast as peers her age and my neurologist tells me it may stop growing all together. Is there anything else I can do? Of course I am stimulating her as much as I can and she smiles, coos, kicks and is very responsive. I know this is just a snapshot of her and I didn't want to go into everything. Any advice? I am desperate to be as proactive as I can because everything that I read says that her brain will develop faster now then later in life. Thank you!
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Dear Kim:

I am very sorry to hear about your daughter's HIE (hypoxic ischemic encephalopathy).  Most of the early developmental landmarks are rudamentary in nature and concerning the beginnings of gross motor function, fine motor function and speech.  So, grave insults occuring very early would not be as influenced on early development.  Where you might see affects is in the higher functions of language and communication, together with more coordinated motor movements.  You are correct in that the most rapid time of brain development and growth is in the first two years of life.  Yes, we feel that early and frequent stimulation is best, as you are currently doing.  The difficulty is in predicting final outcome, for any physician.  Since I can not see the MRI scans or do the physical examination of you daughter it is impossible for any prognostication over the internet.  But, we are often surprised on outcome, especially when the insult was early in development as the brain is a very developmentally plastic (adaptable) organ.  I hope your daughter does well and that her potential is fully attained.

sincerely,

CCF Neuro MD
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