Cerebral hemodynamics and oxygenation in 18 perinatally asphyxiated neonates were compared with 13 healthy controls using near-infrared spectroscopy (NIRS) at the Dept of Pediatrics, University Hospital of Leiden, The Netherlands. Cerebral blood volume (CBV) in the first 12 hours of life was decreased in all of 9 severely asphyxiated neonates who subsequently developed neurologic abnormalities. This decrease in CBV was associated with a drop in HbO2 and cytochrome oxidase. All patients showed stable CBV and enzyme patterns at 12 to 24 hours,. The findings suggest that posthypoxic-ischemic reperfusion injury of the brain occurs during early neonatal life after severe birth asphyxia. 
COMMENT. The decrease in cerebral CBV, oxyhemoglobin, and cytochrome oxidase during the first 12 hours of life are indicators of decreased cerebral perfusion and oxygenation. The authors propose a possible relation between a decreased CBV and adverse neurologic outcome, suggesting a relation between cerebral hypoperfusion and brain tissue damage in severely asphyxiated neonates. NIRS may be used to monitor changes in CBV of neonates.