Year : 2006 | Volume
: 16 | Issue : 4 | Page : 943--944
Radiological quiz - neuroradiology
I Ahmad, F Haque, S Wahab, U Ahmad
D/ O Prof . Abdul Wahab, Kashana e Wahab, Street No. 4 , Iqra Colony, Near Iqra Public School, New Sir Syed Nagar , Aligarh - 202002, India
D/ O Prof . Abdul Wahab, Kashana e Wahab, Street No. 4 , Iqra Colony, Near Iqra Public School, New Sir Syed Nagar , Aligarh - 202002
|How to cite this article:|
Ahmad I, Haque F, Wahab S, Ahmad U. Radiological quiz - neuroradiology.Indian J Radiol Imaging 2006;16:943-944
|How to cite this URL:|
Ahmad I, Haque F, Wahab S, Ahmad U. Radiological quiz - neuroradiology. Indian J Radiol Imaging [serial online] 2006 [cited 2020 Jan 19 ];16:943-944
Available from: http://www.ijri.org/text.asp?2006/16/4/943/32393
A 7 month old infant presented with frequent episodes of seizures , delayed developmental milestones and petechial rash . The infant was born prematurely at 33 weeks of gestational age . Physical examination revealed petechial rash and hepatosplenomegaly . Haematological investigations revealed thrombocytopenia and atypical lymphocytosis . Liver function test of the infant was deranged with conjugated hyperbilirubinemia and elevated alanine aminotransferase levels . CT Scan Brain was done [Figure 1][Figure 2].
What is your diagnosis ?
View AnswerCONGENITAL CMV INFECTION ( CYTOMEGALIC INCLUSION DISEASE )
CT Scan Brain shows widespread bilateral parenchymal calcifications particularly in the periventricular regions with cortical atrophy , ventricular prominence and diffuse hypodensity of periventricular white matter .
Cytomegalovirus is the most common cause of congenital infections .
Cytomegalic inclusion disease develops in 5 % of infected fetuses and is seen almost exclusively in infants born to mothers who develop primary infection during pregnancy  . There may be μ) a fatal infection of fetus involving viscera μμ ) a baby may be born with residual neurological damage or μμμ ) there may be mild disease with only serological and virological evidence of disease .
Fetal infection may occur at any age of gestation . Infants infected with CMV may be born before term . Congenital disease is characterized by thrombocytopenic purpura , hepatosplenomegaly, jaundice and chorioretinitis . Seizures , mental retardation , hydrocephalus , deafness and optic atrophy are later manifestations .
Imaging studies ( CT / MRI ) : Features of cytomegalovirus inclusion disease include
non specific ventricular enlargement , cortical atrophy and parenchymal particularly periventricular calcification . Delayed myelination and neuronal migration anomalies may be seen . In newborns with symptomatic Congenital Cytomegalovirus ( CMV ) infection , neuroimaging is the best available predictor of neurodevelopmental outcome .
The diagnosis of CMV infection is based on isolation of the virus or detection of CMV antigens or DNA from white blood cells , urine , throat or conjuctival swabs . CMV specific Ig M detection may help in the diagnosis of recent infection . Ganciclovir is the drug of choice , however the prognosis is poor and death rate is high.
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