Understanding Kernicterus with MRI

In children with kernicterus, an MRI of the brain can help us “see” the source of neurologic symptoms such as the dyskinetic movements of cerebral palsy. MRI stands for Magnetic Resonance Imaging, and consists of a scanner with a powerful magnet linked to a computer. In conjunction with radio wave pulses of energy, the MRI scanner goes along the body point by point, building a 2-D or 3-D “map” of tissue types. The results are detailed pictures that can be viewed on a monitor or printed out. MRI is unparalleled for viewing soft tissues of the body, such as the brain.

MRI clearly shows the yellow staining and abnormalities that occur in selective areas of the child’s brain caused by kernicterus. MRI is used as an aid in accurately diagnosing kernicterus when viewed in context with TSB (total serum bilirubin) levels and clinical signs of hyperbilirubinemia. Learn more about TSB levels and early kernicterus diagnosis.

Brain regions affected by kernicterus that can be seen with MRI include:

  • Basal ganglia – Buried deep inside the brain, the basal ganglia are clusters of nerve cells that initiate and regulate motor commands. Children whose basal ganglia have been damaged by kernicterus will develop varying degrees of movement disorders. The basal ganglia, especially the regions known as globus pallidus and subthalamic nucleus, represent the site of destruction in the brain from which kernicterus-induced cerebral palsy emerges. 

Before MRI was available, only postmortem studies of tissue specimens under a microscope could confirm kernicterus. Research now shows that MRI of kernicterus brain damage reveals very specific findings, making MRI helpful in ruling out other diagnoses of neonatal brain injury such as hypoxia-ischemia.

The hope is that, in combination with auditory testing and total serum bilirubin (TSB), MRI as a diagnostic tool will lead to improved scientific investigation, diagnosis, and prediction of prognosis of kernicterus.

Subtle Kernicterus and MRI

MRI research also suggests that milder hyperbilirubinemia can produce subtle brain injury. Studies have been done where relatively low levels of bilirubin in preterm newborns were present and signs of acute kernicterus were clinically silent. Still, MRI scans of the infants revealed the signature signs of kernicterus.

This further highlights the dangers of complacency or negligence with regard to monitoring neonatal jaundice. No baby should develop kernicterus. All health care professionals should monitor newborns for jaundice, including discharge risk assessment and follow-up, and adhere to the guidelines set forth by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC).

Behind Every Kernicterus Case Is a Family Who Needs Justice

Parents have the right to learn the truth about what happened to their child. They also need to know that significant help is available to them. At Ratzan Law Group, we believe in seeking and speaking the truth for these children, and helping their families meet a lifetime of challenges.

Do you have reason to believe your child suffered kernicterus brain damage? If so, we know your world has been shattered, through no fault of your own. Please contact us. We are here to help. 

Read more about kernicterus, MRI, and symptoms parents should watch for.