[Comment] Uncertainty in brain imaging after therapeutic hypothermia

After the TOBY trial, which enrolled 325 neonates with hypoxic ischaemic encephalopathy (HIE) and found that total body therapeutic hypothermia improved neurologic outcome in survivors, the implementation of therapeutic hypothermia in neonates with moderate to severe HIE has become a standard of care in many settings, reducing the extent of cerebral lesions and substantially improving clinical outcomes.1,2 Cerebral MRI is a key tool for assessing the extent and pattern of brain injury in infants with moderate-to-severe HIE who underwent therapeutic hypothermia,3 although the clinical interpretation of MRI findings in this group might be challenging.