Congenital cytomegalovirus infection

Case contributed by Dr Dalia Ibrahim

Presentation

Delayed mental and motor milestones.

Patient Data

Age: 9 months
Gender: Male

Right frontotemporal focal atrophy with thick cortex and reduced sulcation (Pachygyri). Absent septum pellucidum and thinned corpus callosum.

Bilateral cerebral periventricular and subcortical scattered calcifications, evident on the right frontotemporal subcortical region.

Right frontotemporal focal atrophy and pachygyri.

Case Discussion

The case illustrates findings of cytomegalovirus infection showing right cerebral frontotemporal focal atrophy and migrational disorder (pachygyri) 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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