Neuroimaging findings associated with congenital Zika virus syndrome: case series at the time of first epidemic outbreak in Pernambuco State, Brazil

Pires, Pedro; Jungmann, Patrícia; Galvão, Jully Moura; Hazin, Adriano Nassri; Menezes, Luiza; Ximenes, Ricardo Arraes de Alencar; Tonni, Gabriele; Júnior, Edward Araujo

doi:10.1007/s00381-017-3682-9

Cited by 23 publications

(29 citation statements)

References 30 publications

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“…Traveller/non-traveller populations: In this update, we found further evidence that congenital abnormalities occurred in infants born to women travellers returning from ZIKV-affected areas and women remaining in those areas. In total, 25 publications report on 272 congenital abnormalities due to ZIKV infection in travellers 27, 29, 30, 32, 34, 36, 38, 42, 45, 56, 58, 61, 89, 94, 98, 109, 117, 122, 123, 137, 140, 151, 153, 166, 173 , with 109 publications reporting congenital abnormalities due to ZIKV in 2652 non travellers 24– 26, 28, 31, 33, 35, 37, 39– 41, 43, 44, 46– 48, 50, 51, 54, 57, 60, 62– 79, 81, 83– 85, 87, 88, 90– 93, 95– 97, 100, 101, 104– 106, 110– 113, 115, 116, 118, 119, 121, 124– 135, 142– 147, 149, 152, 154, 156– 164, 167, 168, 171, 172, 175– 180, 182, …”

Section: Resultsmentioning

confidence: 99%

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

et al. 2019

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Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I2=19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I2=0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I2=0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I2=0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I2=74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.

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Section: Resultsmentioning

confidence: 99%

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

et al. 2019

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“…CT is the best imaging modality for the identification and delineation of calcifications [86]. Compared with prenatal ultrasound, CT was able to detect cerebellar vermis hypoplasia and corpus callosum dysgenesis that was undetected at the prenatal scan [87].…”

Section: Postnatal Computed Tomographymentioning

confidence: 99%

“…Other features of CZS better visualized by postnatal MRI include intraventricular septations, gray matter heterotopia, and schizencephaly [ 56 •]. In addition, MRI is able to better visualize polymicrogyria, most frequently seen in the frontal lobes [ 87 ]. MRI also allows superior visualization of brainstem hypoplasia, cerebellar hemispheric volume loss, and other described abnormalities such as pseudocysts [ 89 ].…”

Section: Neuroimaging Techniquesmentioning

confidence: 99%

Congenital Zika Virus Infection: a Review with Emphasis on the Spectrum of Brain Abnormalities

Vhp

Aragão

Pinho

et al. 2020

Curr Neurol Neurosci Rep

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Purpose of Review In 2016, the World Health Organization declared the Zika virus (ZIKV) outbreak a Public Health Emergency of International Concern following a cluster of associated neurological disorders and neonatal malformations. Our aim is to review the clinical and neuroimaging findings seen in congenital Zika syndrome. Recent Findings ZIKV injures neural progenitor cells in the hippocampus, a brain region important for learning, memory, cognition, and emotion/stress response. Positron emission tomography has revealed global neuroinflammation in ZIKV infection in animal models. Summary Congenital Zika syndrome is associated with a spectrum of brain abnormalities, including microcephaly, parenchymal calcifications, malformations of cortical development and defective neuronal migration, corpus callosum abnormalities, ventriculomegaly, and brainstem and cerebellar abnormalities.

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“…17 documents were excluded because there was no investigation with CT or MRI and 2 because they were experimental studies, resulting in a total of 22 studies. Subsequently, 11 articles were excluded because they were not a case report, and 4 were excluded because they did not include the trimester of gestation that occurred the infection, totalizing 7 articles included [9][10][11][12][13][14][15]. The complete flowchart is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Zika Virus Infection: Review Of Neuroimage Studies And The Relationship Between Findings And Time Of Infection

Radaelli¹,

Lahorgue

Bernardi

et al. 2019

Preprint

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AIM: To conduct a systematic literature review on neuroimage findings in children with microcephaly by Zika virus (ZIKV). METHOD: We performed a literature search in PubMed, Cochrane Library and Web of Science for full-text articles reporting neuroimage exam of computed tomography scan or magnetic resonance imaging. RESULTS: Were identified 2,214 publications. Of these 2,170 were excluded by the analysis of titles and abstracts, resulting in 7 articles included. The abnormalities presented in neuroimage showed the highest occurrence in the first trimester: decreased brain volume + increased extra-axial CSF space (100%), subcortical calcifications (89.1%), microcephaly (89.1%), ventriculomegaly (72.9%), malformation of cortical development (40.5%), basal ganglia calcifications (40.5%), megacisterna magna (39.1%). In relation to the second trimester of ZIKV infection, the most common were as follows: decreased brain volume + increased extra-axial CSF space (100%), subcortical calcifications (100%), microcephaly (85.7%), ventriculomegaly (71.4%), malformation of cortical development (71.4%), basal ganglia calcifications (19%), megacisterna magna (4.7%). In relation to the neuroimage abnormalities detected in the 3rd trimester 2 cases were found. INTERPRETATION: This systematic review is the first that evaluates brain changes in newborns with different neuroimage techniques (CT and MRI exams) and related findings with the gestational period of ZIKV infection.

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Neuroimaging findings associated with congenital Zika virus syndrome: case series at the time of first epidemic outbreak in Pernambuco State, Brazil

Abstract: Severe microcephaly and CNS abnormalities may be associated with congenital ZIKV syndrome.

Cited by 23 publications

References 30 publications

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

Congenital Zika Virus Infection: a Review with Emphasis on the Spectrum of Brain Abnormalities

Zika Virus Infection: Review Of Neuroimage Studies And The Relationship Between Findings And Time Of Infection

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