Neonatal brain injury is a condition that represents an important cause of neonatal morbidity and mortality. Perinatal hypoxia-ischemia affects a significant number of term neonates born in the United States and can result in severe neurologic consequences, including learning disabilities, delayed motor development, seizure disorders, mental retardation and cerebral palsy. It has become an evident that the etiology of neonatal brain injury is multifactorial. The mechanisms underlying this injury are numerous and complex with free radical production, inflammatory mediator activity and excitotoxicity taking precedence.

 

Brain injury generally caused due to either acute or subacute asphyxia is known as Hypoxic-Ischemic Encephalopathy. This imbalance results in the disruption of critical cellular processes. In such cases, gray matter injury predominates as metabolic demand exceeds energy supply. In preterm neonates, however, white matter injury predominates.

 

The neonatal brain presents several barriers that are intrinsically protective but make drug targeting a challenge. These barriers include the blood-brain barrier, Blood-Cerebrospinal Fluid barrier, and Cerebrospinal Fluid -brain barrier.