engleski

Lenticulostriatal Vasculopathy – a Marker for Congenital CMV Infection?

Lenticulostriatal vasculopathy (LSV) is an ultrasonographic (US) brain lesion which appears as branched candlestick - shaped echogenicities or hyperechogenic punctuations located within the basal ganglia (BG) and the thalamus. It has been reported in 0.27-2.5% live neonates, 5.1-32% preterm infants and 1.9-5., 8% ill neonates, the most often in those with congenital cytomegalovirus (CMV) infection. Congenital CMV infection is an important cause of morbidity and mortality in neonates and infants. Brain ultrasonography (US) showed: abnormal echogenicity of the parenchyma, echogenic sulci and gyri, ventricular dilatation, complications and sequellae of the infection (ventriculitis, abscesses, hydrocephalus and calcifications), disturbances of neuronal migration, cerebellar hypoplasia, delays in myelination, SE cysts and LSV. LSV may be caused by a variety of conditions including infection, haemorrhage, hypoxic-ischemic insult, hypoglycaemia, infarction, calcifications, vascular lesions, metabolic disorders or chromosomal abnormalities. Transfontanellar Color Duplex Doppler (TFCD) imaging confirms the vascular origin of these lesions with pulsatile flows as an arterial spectrum. It revealed in the first months of life, but after that time TFCD showed no more flow within the hyperechogenicities, suggesting true calcifications. LSV can be graduated as unilateral or bilateral, isolated or with coexistent abnormalities, grading to minor, moderate and major LSV. The aim of this work is to present TFCD findings in neonates and infants with risk for development of neuromotor disabilities. All infants have US findings of LSV in BG and thalamus. TFCD showed a flow inside during the first few months of life, but with no flow within the echogenicities at the end of the first year. We would like to perform an etiology and graduation of LSV with implications for neurodevelopmental outcome, especially in infants with congenital CMV infection.

lenticulostriatal vasculopathy; congenital cytomegalovirus infection

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