Cerebral lesions in congenital rubella syndrome

Rorke, Lucy B.; Spiro, Alfred J.

doi:10.1016/s0022-3476(67)80419-0

Cited by 129 publications

(32 citation statements)

References 16 publications

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“…In children with AIDS who develop BGC, a calcific vasculopathy mainly involving capillaries and small vessels has recently been described [32] . A similar calcific vasculopathy has been described in some congenital infections, such as congenital rubella [33] ,…”

Section: Discussionsupporting

confidence: 63%

Significance of Basal Ganglia Calcification on Computed Tomography in Children

Legido

Zimmerman²,

Packer

et al. 1988

Pediatr Neurosurg

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We reviewed 6,428 head computed tomography (CT) scans performed on 4,283 children at our institution over a 3-year period and found basal ganglia calcification (BGC) in 48 (1.1%) of the patients. Their mean age at the time of detection was 5.3 years (range: 0.5–20 years); 16 (33%) patients had cancer, 14 (29%) had tuberous sclerosis or congenital infection and 18 (38%) had other medical conditions. All patients with cancer had been treated with radiation therapy, receiving a mean dose of 4,583 cGy (range: 1,800–5,500 cGy) to the diencephalon, and calcifications first became apparent at a median of 10 months after treatment. Other medical conditions included neonatal asphyxia (3), metabolic disease (3) (Kearns Sayre, MELAS, Krabbe’s), congenital anomalies (3), meningitis (2), Fahr’s disease (1) and others (6). Neurologic symptoms were common in children of all groups, but could not be correlated to BGC changes. Calcium and phosphorus metabolism was evaluated in 19 patients and was abnormal in 1. We conclude that BGC on CT in childhood occur primarily as an aftermath of the cancer treatment or in children with generalized neurologic dysfunction. Many children with BGC are delayed in their development, but calcifications are not directly related to specific forms of neurologic dysfunction. Rather, they appear to serve as markers for more extensive brain damage.

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Section: Discussionsupporting

confidence: 63%

Significance of Basal Ganglia Calcification on Computed Tomography in Children

Legido

Zimmerman²,

Packer

et al. 1988

Pediatr Neurosurg

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“…31 Of interest, LSV was first reported in the 1960s after a congenital rubella epidemic in Philadelphia. 32 Postmortem histology of the brains from affected babies showed a highly regionalized vasculitis. For reasons still unknown, the pathologic lesion was limited exclusively to the thalami and basal ganglia.…”

Section: Lenticulostriate Vasculopathymentioning

confidence: 98%

Brain lesions in newborns exposed to high-dose magnesium sulfate during preterm labor

Mittendorf

Dammann

2005

J Perinatol

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High-dosage, tocolytic magnesium sulfate (MgSO 4 ) administered to pregnant women during preterm labor can be toxic, and sometimes lethal, for their newborns (Cochrane Database of Systematic Reviews (relative mortality risk 2.82, 95% confidence interval 1.2-6.6)). Based on the results of the Magnesium and Neurologic Endpoints Trial and the work of many others, a unifying triangular concept is proposed to account for the increased prevalence of brain lesions, with their likely resultant mortality, in neonates and infants exposed to high-dose MgSO 4 in the context of preterm labor. We review the evidence that: (1) elevated circulating levels of serum ionized magnesium occurring in mothers, and therefore in their babies, at the time of delivery are associated with subsequent neonatal intraventricular hemorrhage (IVH); (2) neonatal IVH is strongly associated with lenticulostriate vasculopathy (LSV), an unusual mineralizing lesion involving the thalami and basal ganglia of the neonate; and, (3) exposure to 50 g or more of tocolytic MgSO 4 during preterm labor is associated with the development of LSV.

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“…Some infants also have microvascular disease [6], and most have an altered cellular and humoral immune response to rubella virus [7]. Rubella virus has been isolated from the pancreas of infants at autopsy [3] and intimal proliferation has been documented in pancreatic blood vessels [8]. Between 3 and 12 months of age some infants develop a generalised rash and severe pneumonitis [9].…”

Section: To the Editormentioning

confidence: 99%