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Pediatr Radiol. 2011 Aug;41(8):962-70. doi: 10.1007/s00247-011-2120-5. Epub 2011 May 20.

Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection.

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  • 1Neuroradiology Unit, University Hospital of Padua, Padua, Italy. renzo.manara@sanita.padova.it

Abstract

BACKGROUND:

Congenital cytomegalovirus (CMV) infection can lead to severe neurological sequelae, but a defined brain magnetic resonance (MR) pattern and MR predictors of clinical outcome are still lacking.

MATERIALS AND METHODS:

Clinical and MR findings of 14 children with symptomatic congenital CMV infection were retrospectively reviewed.

RESULTS:

Microcephaly, cerebral palsy and epilepsy were found in eight, six and seven patients, respectively (all concomitant in 6); 12 children developed sensory-neural hearing loss (SNHL). At first MRI (mean age 21 months, range 5-54 months), white matter (WM) involvement was not assessable in two children due to incomplete myelination. WM abnormalities were common (11/12 patients); deep WM was predominantly involved in 5/11; the largest WM lesion was in the parietal lobe in 6/11. Anterior temporal lobe abnormalities were found in 13/14. Six children underwent MRI examination after 2 years of life; in this subgroup, WM abnormalities were extensive and confluent (4/6), bilateral and multifocal (1/6) or absent (1/6). Four children showed a progression of myelination. Ventriculomegaly (9/14), migration disorders (6/14 polymicrogyria and 1/14 pachygyria-lissencephaly) and hippocampal dysplasia (6/14) correlated with severe neurological sequelae (pā€‰<ā€‰0.05, Fisher exact test), while the presence of WM abnormalities (11/12), periventricular cysts (6/14) and cerebellar hypoplasia (4/14) did not predict the outcome.

CONCLUSIONS:

The spectrum of brain MR abnormalities in symptomatic congenital CMV infection is extremely wide. WM involvement is variable, difficult to evaluate at a very young age and unrelated to clinical outcome, while cortical malformations, ventriculomegaly and hippocampal dysplasia seem to be strong predictors of poor outcome except for SNHL.

PMID:
21597906
[PubMed - indexed for MEDLINE]
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