Congenital cytomegalovirus infection

Case contributed by Dalia Ibrahim

Presentation

Microcephaly. Suspected craniosynostosis.

Patient Data

Age: 5 months.
Gender: Female

Corpus callosum agenesis with subsequent widely separated lateral ventricles.

Right cerebral hemiatrophy with ipsilateral asymmetric dilatation of the right lateral ventricle.

Right cerebral insular cortical and deep periventricular and small periventricular calcifications.

Normal cerebellum and brainstem.

3D volume rendering bone window showed microcephaly. No evidence of skull craniosynostosis.

 

Case Discussion

The case illustrates findings of cytomegalovirus infection showing right cerebral hemiatrophy and corpus callosum agenesis with the typical periventricular calcifications.

The mother tested positive for cytomegalovirus antibodies.

Congenital cytomegalovirus infections result from intrauterine fetal infection by cytomegalovirus (CMV), which is a part of the group TORCH infections. It is the most common cause of congenital infective and brain damage.

CT brain findings include:

  • intracranial calcifications: particularly thick and chunky in germinal matrix and periventricular regions with faint and punctate basal ganglia calcifications
  • white matter low density regions
  • ventriculomegaly/cerebral atrophy/destructive encephalopathy
  • neuronal migration disorders

 

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