Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study
| Autor: | Paula Fabiana Sobral da Silva, Regina Ramos Coeli, Maria de Fátima Viana Vasco Aragão, M Carvalho, Maria Angela Wanderley Rocha, Ana van der Linden, Alessandra Mertens Brainer-Lima, Marcelo Moraes Valença, Arthur Cesário de Holanda, Vanessa van der Linden |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Pathology medicine.medical_specialty Microcephaly Cisterna magna Corpus callosum Nerve Fibers Myelinated Corpus Callosum White matter Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Cisterna Magna medicine Polymicrogyria Humans Pregnancy Complications Infectious Retrospective Studies Zika Virus Infection business.industry Pachygyria Infant Newborn Brain Calcinosis Infant Organ Size Zika Virus General Medicine medicine.disease Magnetic Resonance Imaging White Matter Hypoplasia Malformations of Cortical Development 030104 developmental biology medicine.anatomical_structure Immunoglobulin M Female Agenesis of Corpus Callosum Tomography X-Ray Computed business Brazil 030217 neurology & neurosurgery Hydrocephalus Ventriculomegaly |
| Zdroj: | BMJ. :i1901 |
| ISSN: | 1756-1833 |
| DOI: | 10.1136/bmj.i1901 |
| Popis: | Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans. Results Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus—the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases. Conclusion Severe cerebral damage was found on imaging in most of the children in this case series with congenital infection presumably associated with the Zika virus. The features most commonly found were brain calcifications in the junction between cortical and subcortical white matter associated with malformations of cortical development, often with a simplified gyral pattern and predominance of pachygyria or polymicrogyria in the frontal lobes. Additional findings were enlarged cisterna magna, abnormalities of corpus callosum (hypoplasia or hypogenesis), ventriculomegaly, delayed myelination, and hypoplasia of the cerebellum and the brainstem. |
| Databáze: | OpenAIRE |
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