Latest developments in the use of e-cigarettes by people with schizophrenia spectrum disorders who smoke: a scoping review.

Neonatal encephalopathy (NE) remains a leading cause of mortality and long-term neurodevelopmental disability in term and near-term infants, with hypoxic–ischemic encephalopathy (HIE) accounting for the largest proportion (; ). Therapeutic hypothermia (TH) has become the standard of care for moderate to severe HIE and has substantially improved survival and overall neurological outcomes. Nevertheless, difficulties across multiple domains–including motor coordination, learning, language, and emotional/behavioral regulation–are still observed at school age, underscoring the importance of early risk stratification and long-term follow-up (; ; ). Against this backdrop, the role of neuroimaging in HIE management has shifted earlier and gained greater weight. Contemporary imaging strategies for NE/HIE are MRI-centered (). Diffusion-weighted imaging (DWI) delineates patterns of hypoxic–ischemic injury, susceptibility-weighted imaging (SWI) identifies hemorrhagic burden while providing venous information, and proton magnetic resonance spectroscopy (H-MRS) may be incorporated to strengthen prognostic assessment. In infants treated with TH, the optimal time window for DWI assessment typically falls after rewarming, around postnatal days 4–6 (). When clinical features or structural imaging raise concern for stroke or venous system involvement, adjunct arterial and venous imaging (MRA/MRV) facilitates etiologic classification and informs management decisions (). Within this context of increasingly refined imaging, intracranial hemorrhage (ICH) is detected more frequently, yet its clinical significance is heterogeneous. MRI studies from historical HIE cohorts have shown that multiple hemorrhage subtypes may coexist with hypoxic–ischemic injury and are associated with more severe clinical encephalopathy and hemodynamic instability (; ). In contrast, studies in TH-treated populations suggest that although approximately one third of infants demonstrate ICH on MRI, hemorrhage does not exert an independent effect on neurodevelopmental outcome; rather, HIE-related MRI and MRS abnormalities remain the dominant prognostic determinants. These observations indicate that the simple distinction of “bleeding versus no bleeding” is not enough for risk stratification (; ).