Neonatal hypoxic-ischemic encephalopathy, or HIE, often shows a localized hypointense shadow, or cerebral edema, on early imaging. Clinicians will often determine whether a child has HIE based on clinical symptoms and imaging findings, and then give the corresponding supportive treatment. The hypointense shadow often disappears when the child is reexamined one month later. At this point, many clinicians consider the HIE cured and then tell the parents that the child is well enough to be discharged. But while parents rejoice, there are some children for whom tragedy often begins. Of course, if the child is regularly followed up and observed, the tragedy is often corrected and prevented. Unfortunately, however, many people equate HIE with the common cold. When a cold is treated and its natural immune response process clears up the symptoms, it often also represents a cure. However, with hypoxic-ischemic encephalopathy, the disappearance of cerebral edema only indicates the end of this one injury. The clinical consequences of its damage to the brain will gradually manifest themselves during its later development. Not just momentary clinical symptoms and imaging changes. This is a child I recently saw, who had a typical treatment experience. The images below are from 3 days, 1 month, and 9 months after birth. His treatment process is typical. After birth, because the child was found to be unresponsive, the first film was checked and reported ischemic-hypoxic encephalopathy, and intravenous neurotrophic drugs were administered for about 2 weeks. The CT was rechecked at full term and the report card said it was normal. At the age of 2 years and 2 months, the child was found to be significantly behind normal children of the same age, unable to pronounce words, not recognizing people, and having weakness in both lower limbs. He was told that he had cerebral palsy. By this time, the best time for treatment had passed. At this time, tragedy has already been caused. As we all know, rehabilitation therapy lies in the plasticity of the brain, and the faster the brain develops, the stronger the plasticity. Therefore, the best time for rehabilitation is divided into super early (1 – 3 months), early (3-6 months), when treatment is often done with half the effort, and after this time is often done with half the effort. Of course it is much more than that in the long term, it is possible to treat to a very good level at 3 months and not to reach that level even with 12 or even 20 times more time and effort after a few years of age. For a child, the month, duration and degree of hypoxia vary, so does the location and degree of injury, and its clinical manifestations are even different. In outpatient clinics, I often see children around 10 years old, because they walk unsteadily, or find that one foot is turned inward, or study very hard but do poorly in school, when tracing the medical history, there is often an incident of hypoxia. I always compare raising a child to planting a small tree. When you see a small tree with a fork, when it grows crooked, you have to cut it off or straighten it early, otherwise it will be difficult to correct it once it grows crooked. For the child we have to raise, while observing, once found the child has a problem to correct in time. We should not only observe the child’s motor development, but also pay attention to the child’s intelligence, behavior, and the development of hearing and vision. Once ischemic-hypoxic encephalopathy occurs, it may have long term effects on the child. Early detection and treatment is the key, and follow-up observation and evaluation is also very important. As a pediatric rehabilitation doctor, patience in treating the child is the key, and guarding the child’s later development is even more critical.