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Periventricular areas of decreased attenuation coefficient were demonstrated by computed tomography (CT) in two infants with neurological involvement after episodes of neonatal hypoxia. This CT finding is related to anoxic periventricular leukomalacia, which is well documented in the literature. Follow-up CT scans in our two patients demonstrated reversibility of the white matter changes.

Neonatal hypoxia is a major cause of morbidity and mortality in new-borns (NB). Fetal asphyxia has traditionally been diagnosed and graded using clinical signs (meconium-staining, fetal bradycardia, Apgar score [1]) and biochemical parameters (pH, lactate [2]). However, the sensitivity and specificity of these indices are not optimal and more accurate methods for assessing hypoxia are needed.

The present study includes 50 cases of cerebral palsy. The possible etiological factors were forceps application or caeserean section in 7 cases, neonatal jaundice in 2 cases, neonatal hypoxia in 3 cases, breech delivery in 2 cases, history of high fever and convulsions in 2 cases, head injury in 4 cases, premature and post mature delivery in 4 cases and in one case the child did not cry for 2 days.

I share Dr. Prod'hom's enthusiasm concerning the article by Sinclair, Engel, and Silverman on the treatment of hypoxia and acidosis in low birth weight infants, which was in the October issue of Pediatrics. We have long needed an article such as this. Hopefully similar articles will follow to enlighten us more on this perplexing subject. I would like to make a new comments on the article in subject with respect to the use of intravenous sodium bicarbonate.