Imaging of congenital central nervous system infections

Neuberger, Ilana; García, J. Rodríguez; Meyers, Mariana L.; Feygin, Tamara; Bulas, Dorothy; Mirsky, David M.

doi:10.1007/s00247-018-4092-1

Cited by 33 publications

(30 citation statements)

References 70 publications

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“…The central nervous system disruption secondary to the infectious insult is related to both the primary insult caused by the pathogen-specific endotoxins and the host's inflammatory response. The fetal brain is particularly sensitive to neurotropic organisms, especially in the first and second trimesters [29].…”

Section: Discussionmentioning

confidence: 99%

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Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Wilson

2020

Fetal Diagn Ther

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Background: The prevalence of perinatal infection from maternal exposure is increasing. The prevalence of acute maternal infections identifies cytomegalovirus, parvovirus B19, toxoplasmosis, and varicella as the most common organisms and in the order of frequency. Maternal informed consent and understanding is required before intrauterine testing for fetal infectious and possible genetic risk assessment. Methods: This structured review of the reproductive published literature focuses on the risks of amniocentesis and cordocentesis diagnostic procedure-related fetal loss rates and fetal vertical transmission (VT) rates from published infected pregnant cohorts. Results: The total postprocedure fetal loss rate for diagnostic amniocentesis procedures, in limited infectious cohorts, is 1.5% and does not appear to be increased compared to "noninfected" amniocentesis cohorts using an estimated background spontaneous fetal loss rate (no procedure) of 0.65%. The "pooled" unintended fetal loss rate is from small infected population cohorts, but can be used for counseling purposes. Postcordocentesis fetal loss risk, in an infected cohort, is not possible to estimate due to limited data. The "biological spontaneous fetal loss rate" risk with a perinatal infection (positive or negative fetal anomalies) and no diagnostic procedure before 20 weeks of gestation is reviewed. The risk of VT in acute infection cohorts as a result of the intra-amniotic diagnostic procedure is not found to be increased. Conclusion: The unintended "fetal loss" rate after amniocentesis for perinatal infected cohorts is similar to that of noninfected cohorts, but the estimate is based on limited infected cohorts. There was no procedure-based risk of fetal VT in the infected cohorts, but identification of postprocedure maternal bleeding into the amniotic cavity increases the potential risk. Maternal knowledge translation and an informed consent process with risk-benefit maternal/fetal risk counseling are required prior to any diagnostic amniocentesis procedure.

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Section: Discussionmentioning

confidence: 99%

“…Corresponding viral DNA was found in 6 of 7 maternal blood samples with human herpesvirus 6-positive amniotic fluid and in one umbilical cord plasma sample [27]. Table 1 summarizes the US and MRI features (head, thorax, cardiac, abdominal, amniotic fluid, and placental) for identified fetal infections [6,26,28,29].…”

Section: Questionmentioning

confidence: 99%

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Wilson

2020

Fetal Diagn Ther

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“…Other observed alterations are occipital prominence, cerebellar hypoplasia, and pontine hypoplasia [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . The simplified gyral pattern is likely the result of the disruption of neuronal proliferation and induction of neuronal progenitor cell apoptosis [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . This was the predominant finding in our sample, present in 97.0% of cases and was extensively simplified in the majority (82.3%) of cases, reflecting the presence of lissencephaly or lissencephaly with focal areas of pachygyria.…”

Section: Discussionmentioning

confidence: 99%

“…Parenchymal calcifications are common in patients with congenital ZIKV syndrome and they exhibit a predilection for the cortical-subcortical junction, suggesting vascular involvement by the infection [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][19][20] . We identified calcifications in 94.1% of patients and localization at the cortical-subcortical junction in 88.2% of cases; calcification was thus more common in the parietal and frontal lobes, as in other studies 2,3,5,7,16 .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the frequency of neuroimaging findings in congenital infection by Zika virus and differences between computed tomography and magnetic resonance imaging in the detection of alterations

Ribeiro¹,

Muniz²,

Marchiori

2020

Rev. Soc. Bras. Med. Trop.

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Introduction: Congenital infection by the Zika virus (ZIKV) is responsible for severe abnormalities in the development of the central nervous system. The aim of this study was to evaluate and compare the ability of computed tomography (CT) and magnetic resonance (MR) to detect patterns of involvement of the central nervous system in congenital ZIKV syndrome. Methods: We retrospectively analyzed CT and MR images from 34 patients with congenital ZIKV syndrome and evaluated the differences between the two methods in detecting alterations. Results: The predominant radiographic finding was a simplified gyral pattern, present in 97% of cases. The second most common finding was the presence of calcifications (94.1%), followed by ventriculomegaly (85.3%), dysgenesis of the corpus callosum (85.3%), craniofacial disproportion and redundant scalp (79.4%), complete opercular opening (79.4%), occipital prominence (44.1%), cerebellar hypoplasia (14.7%), and pontine hypoplasia (11.8%). The gyral pattern was extensively simplified in most cases, and calcifications were located predominantly at the cortical-subcortical junction. CT was able to better identify calcifications (94.1% × 88.2%), while MRI presented better spatial resolution for the characterization of gyral pattern (97% × 94.1%) and corpus callosum dysgenesis (85.3% × 79.4%). Conclusions: Although congenital ZIKV syndrome does not present pathognomonic neuroimaging findings, some aspects, such as calcifications at the cortical-subcortical junction, especially when associated with compatible clinical and laboratory findings, are suggestive of intrauterine ZIKV infection.

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Neonatal herpes simplex virus infection: From the maternal infection to the child outcome

De Rose,

Bompard,

Maddaloni

et al. 2023

Journal of Medical Virology

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This review examines the recent literature on the management of herpes simplex virus (HSV) infections in neonates. We summarized the three clinical categories of maternal HSV infection during pregnancy (primary first episode, nonprimary first episode, or recurrent episode) and the mechanisms of fetal damage. Considering when the transmission of the infection from the mother to the fetus/newborn occurs, three types of neonatal infection can be distinguished: intrauterine infection (5% of cases), postnatal infection (10% of cases), and perinatal infections (85% of cases). Neonatal presentation could range from a limited disease with skin, eye, and mouth disease to central nervous system disease or disseminated disease: the treatment with acyclovir should be tailored according to symptoms and signs of infection, and virological tests. These children need a multidisciplinary follow‐up, to timely intercept any deviation from normal neurodevelopmental milestones. Prevention strategies remain a challenge, in the absence of an available vaccine against HSV.

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Imaging of congenital central nervous system infections

Cited by 33 publications

References 70 publications

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Acute Perinatal Infection and the Evidenced-Based Risk of Intrauterine Diagnostic Testing: A Structured Review

Evaluation of the frequency of neuroimaging findings in congenital infection by Zika virus and differences between computed tomography and magnetic resonance imaging in the detection of alterations

Neonatal herpes simplex virus infection: From the maternal infection to the child outcome

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