Abstract: Objective To evaluate the hemodynamic changes in the central branches of the middle cerebral artery in different
stages of neonatal hypoxic-ischemic encephalopathy (HIE) and provide new evidence for clinical diagnosis of HIE. Methods
From March, 2013 to July, 2013, a total of 136 newborn infants were diagnosed to have HIE in our center. We performed
two-dimensional ultrasonography and color Doppler ultrasound for assessments of systolic velocity (Vs) and resistant index
(RI) of the central branches of the middle cerebral artery. The data were compared with the results of a control group
consisting of 251 normal full-term infants. Results Infants with mild HIE showed hyperechoic changes in the white matter
around the ventricle, while in moderate and severe HIE, such hyperechoic changes were diffuse in both hemispheres with
unclear echoes of the brain structures. Pulse Doppler assessments of hemodynamics of the central branches of the middle
cerebral artery demonstrated a significant decrease in Vs and an increase in RI regardless of HIE severity (P<0.05). In addition,
Vs and RI values in mild HIE infants differed significantly (P<0.05) from those in infants with moderate and severe HIE, who
had comparable Vs and RI values (P>0.05). Conclusion Transcranial ultrasonography may provide dynamic information on
cerebral blood flow in neonates and hemodynamic parameters of the central branches of the middle cerebral artery are
valuable for clinical diagnosis and early intervention of HIE.