Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis

Aragão, Máría de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Holanda, Arthur Cesário de; Linden, Vanessa van der; Aragão, L. Vasco; Júnior, Mário Luciano de Mélo Silva; Sarteschi, Camila; Petribu, N C L; Valênça, Marcelo Moraes

doi:10.3174/ajnr.a5125

Cited by 53 publications

(62 citation statements)

References 25 publications

(21 reference statements)

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“…Arthrogryposis, or congenital contractures, may also occur in association with brain stem hypoplasia and thinning of the entire spinal cord. (17) In summary, the extreme phenotype of the CZS is well described and clinically straightforward to diagnose using antenatal ultrasound and/or magnetic resonance imaging (MRI) and clinical examination.…”

Section: Congenital Zika Syndrome and Diagnostic Challengesmentioning

confidence: 99%

Zika virus and the nonmicrocephalic fetus: why we should still worry

Walker

Little²,

Roby

et al. 2019

American Journal of Obstetrics and Gynecology

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Zika virus (ZIKV) is a mosquito-transmitted flavivirus and was first linked to congenital microcephaly due to a large outbreak in Northeastern Brazil. Although the ZIKV epidemic is now in decline, pregnancies in large parts of the Americas remain at risk due to ongoing transmission and the potential for new outbreaks. This review presents why Zika virus is still a complex and worrisome public health problem with an expanding spectrum of birth defects and why ZIKV and related viruses may evade the immune response to injure the fetus. Recent reports indicate that the spectrum of fetal brain and other anomalies associated with ZIKV exposure is broader and more complex than microcephaly alone and includes subtle fetal brain and ocular injuries; thus, the ability to prenatally diagnose fetal injury associated with ZIKV infection remains limited. New studies indicate that ZIKV imparts disproportionate effects on fetal growth with an unusual femur-sparing profile, potentially providing a new approach to identify viral injury to the fetus. Studies to determine the limitations of prenatal and postnatal testing for detection of ZIKV-associated birth defects and long-term neurocognitive deficits are needed to better guide counseling for women with a possible infectious exposure. It is also imperative that we investigate why ZIKV is so adept at infecting the placenta and the fetal brain to better predict other viruses with similar capabilities that may give rise to new epidemics. The efficiency with which ZIKV evades the early immune response to enable infection of the mother, placenta and fetus is likely critical for understanding why the infection may either be fulminant or limited. Furthermore, studies suggest that several emerging and related viruses may also cause birth defects, including West Nile virus, which is endemic in many parts of the United States. With mosquito-borne diseases increasing worldwide, there remains an urgent need to better understand the pathogenesis of ZIKV and related viruses to protect pregnancies and child health.

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Section: Congenital Zika Syndrome and Diagnostic Challengesmentioning

confidence: 99%

Zika virus and the nonmicrocephalic fetus: why we should still worry

Walker

Little²,

Roby

et al. 2019

American Journal of Obstetrics and Gynecology

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“…According to Oliveira-Szejnfeld et al [21], infratentorial calcifications are present in more severe cases associated with brainstem dysmorphia, aqueduct stenosis, and secondary hydrocephalus. Aragão et al [31] corroborated this observation, reporting that infratentorial calcifications were more likely in the presence of arthrogryposis. On evolutionary follow-up, children with CZVS show reductions in the number, size, and density of calcifications, except those involving the basal and cerebellar nuclei [36].…”

Section: Infratentorial Parenchymal Calcificationsmentioning

confidence: 71%

“…Calcifications are common in CZVS, occurring in 88-100% of patients. Unlike the classic TORCH infections Eur Neurol 2020;83:17-24 DOI: 10.1159/000505834 (toxoplasmosis, other agents [e.g., HIV, syphilis] rubella, cytomegalovirus, and herpes simplex), in which calcifications are periventricular and cortical, ZIKV involvement tends to appear with cortical-subcortical transition, leading to the suggestion that it has a vascular infection component, as other processes that affect mainly this region are associated with vascular alterations [21,[24][25][26][27][28][29][30][31][32]. The infratentorial region is the least common site of involvement, affected in only 4-18% of cases; calcifications are seen more frequently in the basal nuclei/thalamus (29-65%), periventricular region (14-65%), and cortical region (14-24%) [21,[24][25][26][27][28][29][33][34][35].…”

Section: Infratentorial Parenchymal Calcificationsmentioning

confidence: 99%

What We Can Find Beyond the Classic Neuroimaging Findings of Congenital Zika Virus Syndrome?

Niemeyer

Hollanda²,

Muniz³

et al. 2020

Eur Neurol

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Background: In 1947, Zika virus (ZIKV) was first discovered in Monkeys, in Zika Forest, in Uganda, Africa. Five years later, (1952) the first human Zika infection was detected in Nigeria, Africa. After this date, only sporadic cases happened, until the first 3 epidemics occurred, all outside Africa. The first epidemic was in Yap Island in 2007, the second in French Polynesia in 2013, and the third in 2015 in the northeast of Brazil, and then the spread to the Americas in 2015 and 2016. However, it was only after the epidemic in the northeast of Brazil, in the first half of 2015, that many babies were born with microcephaly in the second semester of that same year and in 2016. Until now, every year, some babies are still born with congenital ZIKV syndrome (CZVS). Summary: The objective of this article is to describe infrequent and rarely discussed imaging (computed tomography and magnetic resonance imaging) findings of CZVS, in addition to those classically described such as a simplified gyral pattern, ven-triculomegaly, corpus callosum dysgenesis, craniofacial disproportion, and redundant scalp, thus suggesting an increase in the spectrum of neurological findings related to the syndrome.

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“…Los hallazgos por imágenes pueden ser: microcefalia, calcificaciones cerebrales subcorticorticales, alteraciones en el patrón de los giros, ventriculomegalia, anormalidades del cuerpo calloso, disminución de los volúmenes cerebrales y agrandamiento de la cisterna magna y espacio subaracnoideo extraaxial 13,14 . En este estudio se encontraron tres casos con sospecha de infección por Zika, dos se confirmaron por reacción en cadena de la polimerasa (PCR) para Zika en cordón umbilical y líquido amniótico.…”

Section: Discussionunclassified

Descripción de la experiencia en RM cerebral fetal en Cali - Colombia

Granados

Ospina

2017

Rev. chil. radiol.

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IntroducciónEl primer caso reportado de uso de resonancia magnética durante el embarazo fue en 1983, para confirmar la presencia de acretismo placentario 1 . En las últimas tres décadas la resonancia magnética fetal (RMF) ha revolucionado el diagnóstico en útero de patologías fetales, ya que tiene muchas ventajas sobre la ultrasonografía (US) prenatal, no está limitada por obesidad materna, la posición fetal o la presencia de Cali -Colombia. Rev Chil Radiol 2017; 23(4): 187-192.

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Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis

Cited by 53 publications

References 25 publications

Zika virus and the nonmicrocephalic fetus: why we should still worry

Zika virus and the nonmicrocephalic fetus: why we should still worry

What We Can Find Beyond the Classic Neuroimaging Findings of Congenital Zika Virus Syndrome?

Descripción de la experiencia en RM cerebral fetal en Cali - Colombia

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