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
184 - Congenital Cytomegalovirus Infection
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 most common imaging finding of congenital cytomegalovirus (CMV) infection is intracranial calcifications (in 33–70% of patients), which are typically periventricular thick and chunky, while faint and punctate in other locations. Absence of calcifications does not exclude congenital CMV infection. While calcifications are best seen on CT, MRI is the modality of choice for all other lesions. Neuronal migration abnormalities (in up to 10%) range from lissencephaly to diffuse or focal polymicrogyria. White matter abnormalities (up to 22%) are of low CT attenuation and T1 signal (and high T2 signal over 8–10 months of age), and abnormal anterior temporal white matter, primarily vacuolization and cyst formation, is characteristic. Ventriculomegaly is common (in 10–45%), with or without microcephaly and cerebellar hypoplasia. The most specific findings in children with neurodevelopmental delay are cortical malformations, white matter abnormalities, cerebellar hypoplasia, and temporal lobe lesions. Multifocal predominantly deep parietal white matter lesions in patients with static encephalopathy are indicative of congenital CMV infection. In asymptomatic individuals a posterior-predominant pattern with preserved periventricular and subcortical white matter is characteristically found.
Pertinent Clinical Information
Congenital CMV infection is the most common intrauterine infection, occurring in 0.15–2.0% of all live births. Confirmatory tests are polymerase chain reaction (PCR) in amniotic fluid and virus isolation from urine in the first weeks of life. Neonatal signs of infection include jaundice, hepatosplenomegaly, petechiae, microcephaly, and chorioretinitis. About 90% of affected infants are, however, asymptomatic at birth, and only 10–15% of these will develop persistent problems, primarily sensorineural hearing loss, mental retardation, cerebral palsy, and seizures.
- Type
- Chapter
- Information
- Brain Imaging with MRI and CTAn Image Pattern Approach, pp. 381 - 382Publisher: Cambridge University PressPrint publication year: 2012