Congenital central nervous system (CNS) infections are a cause of significant morbidity and mortality. The recent Zika virus outbreak raised awareness of congenital CNS infections. Imaging can be effective in diagnosing the presence and severity of infection. In this paper we review the clinical presentations and imaging characteristics of several common and less common congenital CNS infections.

The aims of this study were to perform a comprehensive expression analysis of the genes encoding extracellular matrix proteins and to investigate the expression pattern in one of these proteins, syndecan 1, in normal ovarian epithelium as well as benign and malignant ovarian serous tumors. Gene expression of 16 different extracellular matrix proteins was analyzed in ovarian serous tumors based on serial analysis of gene expression database. Semiquantitative reverse transcription-polymerase chain reaction was used to validate the serial analysis of gene expression result from each gene. As compared with normal ovarian surface epithelium, we found overexpression of syndecan 1, collagen type IV alpha 2, elastin microfibril interfase located protein 1, and laminin 5 in ovarian serous carcinomas. Syndecan 1 was selected for further study as it has not been well characterized in ovarian cancer and the syndecan 1 antibody was available for immunohistochemistry. Using a syndecan 1-specific monoclonal antibody, we demonstrated that syndecan 1 was expressed in 30.4% of high-grade serous carcinomas, 29.7% of low-grade carcinomas and serous borderline tumors, but none of benign serous cystadenomas and ovarian surface epithelium. Although both high-grade and low-grade serous carcinomas had a similar percentage of syndecan 1-positive cases, the immunointensity in high-grade carcinoma was significantly higher than that in low-grade carcinomas and serous borderline tumors (P = 0.007). In summary, ovarian carcinomas exhibit up-regulated expression of several extracellular matrix proteins, and syndecan 1 represents a novel tumor-associated marker in ovarian serous carcinomas.

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Chordomas are rare bony neoplasms usually unassociated with a familial tumor predisposition syndrome. The peak incidence of this midline axial skeletal tumor is in adulthood but when very young children are affected, consideration should be given to occurrence within the tuberous sclerosis (TS) complex, especially when presenting in neonates <3 months of age. To call attention to this association, we present a brachyury-immunopositive chordoma occurring in the skull base of a 2-month-old male infant who was later realized to have metastases to the subcutaneous tissues and lungs, as well as rhabdomyoma of the heart and renal cysts/angiomyolipomas, that is, characteristic features of the TS complex. We review the limited literature on this topic.

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Background/Aims: Seizures, strokelike episodes, and headaches are common complications in patients with Sturge-Weber syndrome. Based on our experience, we hypothesized that patients with Sturge-Weber syndrome have frequent urgent neuroimaging studies when presenting acutely to the emergency department. In this study, we aimed to determine the incidence of acute imaging studies in this patient population and to evaluate the prevalence of findings such as acute intracranial hemorrhagic or ischemic strokes. Methods: To determine the frequency and yield of brain imaging, we conducted a retrospective chart analysis in patients with Sturge-Weber syndrome who presented to Boston Children's Hospital with acute neurologic symptoms between 1996 and 2016. Results: We reviewed 136 encounters of patients with Sturge-Weber syndrome. In 73 of 136 encounters (53.7%), patients underwent a total of 89 imaging studies, consisting of 47 head computed tomographies (CTs) and 42 brain magnetic resonance images (MRIs). Twenty-two percent of patients imaged underwent both CT and MRI scanning of the brain. Patients with strokelike episodes or headaches were more likely to be imaged compared to patients presenting with seizures (89.7% and 100% vs 34.4%, respectively). None of the neuroimaging studies showed acute hemorrhagic or ischemic strokes. Conclusions: Acute neurologic manifestations of Sturge-Weber syndrome frequently lead to urgent neuroimaging. In our cohort, there was no imaging evidence of acute hemorrhagic or ischemic strokes. In addition, emergent imaging in patients presenting with breakthrough seizures did not result in meaningful changes in management.