Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- Section 1 Bilateral Predominantly Symmetric Abnormalities
- Section 2 Sellar, Perisellar and Midline Lesions
- Section 3 Parenchymal Defects or Abnormal Volume
- Section 4 Abnormalities Without Significant Mass Effect
- Section 5 Primarily Extra-Axial Focal Space-Occupying Lesions
- Section 6 Primarily Intra-Axial Masses
- Section 7 Intracranial Calcifications
- 184 Congenital Cytomegalovirus Infection
- 185 Congenital Toxoplasmosis
- 186 Aicardi–Goutieres Syndrome
- 187 Physiologic Basal Ganglia Calcifications
- 188 Hyperparathyroidism
- 189 Meningioangiomatosis
- 190 Vascular Wall Calcification
- 191 Dystrophic Calcifications
- 192 Calcified Aneurysms
- 193 Vascular Malformations
- 194 Cysticercosis
- 195 Calcified Metastases
- 196 Ganglioglioma
- 197 Oligodendroglioma
- 198 Cortical Tubers in Tuberous Sclerosis
- 199 Subependymal Nodules in Tuberous Sclerosis
- 200 Ependymoma
- 201 Lipoma With Calcification
- 202 Craniopharyngioma
- 203 Meningioma
- 204 Teflon Granuloma
- Index
- References
185 - Congenital Toxoplasmosis
from Section 7 - Intracranial Calcifications
Published online by Cambridge University Press: 05 August 2013
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- Section 1 Bilateral Predominantly Symmetric Abnormalities
- Section 2 Sellar, Perisellar and Midline Lesions
- Section 3 Parenchymal Defects or Abnormal Volume
- Section 4 Abnormalities Without Significant Mass Effect
- Section 5 Primarily Extra-Axial Focal Space-Occupying Lesions
- Section 6 Primarily Intra-Axial Masses
- Section 7 Intracranial Calcifications
- 184 Congenital Cytomegalovirus Infection
- 185 Congenital Toxoplasmosis
- 186 Aicardi–Goutieres Syndrome
- 187 Physiologic Basal Ganglia Calcifications
- 188 Hyperparathyroidism
- 189 Meningioangiomatosis
- 190 Vascular Wall Calcification
- 191 Dystrophic Calcifications
- 192 Calcified Aneurysms
- 193 Vascular Malformations
- 194 Cysticercosis
- 195 Calcified Metastases
- 196 Ganglioglioma
- 197 Oligodendroglioma
- 198 Cortical Tubers in Tuberous Sclerosis
- 199 Subependymal Nodules in Tuberous Sclerosis
- 200 Ependymoma
- 201 Lipoma With Calcification
- 202 Craniopharyngioma
- 203 Meningioma
- 204 Teflon Granuloma
- Index
- References
Summary
Specific Imaging Findings
The involvement of the brain in congenital toxoplasmosis may range from mild to severe. Subtle to coarse and chunky calcifications without periventricular predilection are commonly present and randomly distributed. There is destruction of the brain parenchyma with hydrocephalus and atrophy in severe cases. Ventriculomegaly is due to aqueductal atresia from ependymal involvement and shows a somewhat typical posterior predominance. In addition to calcifications, CT may show focal hypodense areas in the white matter. US demonstrates calcifications and cystic lesions in the periventricular white matter. Lenticulo-striate vasculopathy (LSV) with hyperechogenic linear branching structures corresponding to vasculature is a nonspecific finding, suggesting an infectious process. Ultrasound and CT have comparable sensitivity for intracranial calcifications of congenital toxoplasmosis. MR findings include periventricular foci of bright T1 signal due to calcification and gliosis. T2-weighted images demonstrate cystic white matter lesions and abnormal white matter hyperintensity due to gliosis, while the calcifications are dark. Recent cystic changes may be bright on DWI and show decreased diffusivity from cytotoxic edema. MR spectroscopy is not specific, but may reveal a prominent lactate peak. In contrast to CMV, cortical malformations such as polymicrogyria are infrequent.
Pertinent Clinical Information
Congenital toxoplasmosis is caused by transplacental contamination of the fetus following maternal primary infection. It is substantially less frequent than cytomegalovirus (CMV) infection; however, it is more commonly symptomatic. Education and serological screening of pregnant women are the only currently available strategies for the prevention, diagnosis, and treatment since the infection usually goes unrecognized in pregnant women.
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- Information
- Brain Imaging with MRI and CTAn Image Pattern Approach, pp. 383 - 384Publisher: Cambridge University PressPrint publication year: 2012