engleski

Malformations of Cortical Development in Children with Congenital Cytomegalovirus Infection

Congenital cytomegalovirus (CMV) infection is the most common transplacentary transmitted viral infection, occuring in approximately 1% of live born neonates. CMV may cause multiorgan affection but organ specific disease, with the most serious and permanent sequelae to central nervous system (CNS). Advanced diagnostic methods in particularly laboratory and neuroimaging contribute to better recognition of congenital CMV infection. Congenital CMV infection may disturbe neurogenesis of CNS. Structural abnormalities of the CNS are related to the timing of affected neurogenetic processes. Early-onset infection before 16-18 weeks of gestation causes severe disorder of neuronal proliferation, migration and cerebellar hypoplasia. We present 7 children with brain malformations and proven congenital CMV infection.In all children congenital CMV infection was confirmed by specific serology, PCR for CMV DNA and/or virus urine excretion. All children underwent MRI, and 4 of them cranial CT. All 7 children have complex brain malformations : lissencephaly in 2 children, in one of them accompanied by cerebellar hypoplasia , parenchymal calcification and callosal hypoplasia. Another 4 children have widespread cortical dysgenesis (pachygyria/polymicrogyria), accompanied by cerebellar hypoplasia callosal hypoplasia parenchymal cysts and calcification.Microcephaly was present in all children, reflecting severely disturbed brain development. Brain malformations caused by congenital CMV infection are severe and complex affecting cortical organisation, neurogenesis of cerebellum, parenchymal cysts and callosal hypoplasia. Calcifications are present in 4 out 7 children, which was better visualized by cranial CT. Severe and complex brain malformations causing cortical dysgenesis, cerebelar hypoplasia indicate an early-onset infection.

congenital cytomegalovirus infection ; cortical malformations

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