Sarah B Mulkey1, Gilbert Vezina2, Dorothy I Bulas3, Zarir Khademian2, Anna Blask2, Youssef Kousa4, Caitlin Cristante5, Lindsay Pesacreta5, Adre J du Plessis6, Roberta L DeBiasi7. 1. Division of Fetal and Transitional Medicine, Children's National Health System, Washington, District of Columbia; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia. Electronic address: sbmulkey@childrensnational.org. 2. Division of Radiology, Children's National Health System, Washington, District of Columbia. 3. Division of Fetal and Transitional Medicine, Children's National Health System, Washington, District of Columbia; Division of Radiology, Children's National Health System, Washington, District of Columbia. 4. Division of Neurology, Children's National Health System, Washington, District of Columbia. 5. Division of Fetal and Transitional Medicine, Children's National Health System, Washington, District of Columbia. 6. Division of Fetal and Transitional Medicine, Children's National Health System, Washington, District of Columbia; Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia. 7. Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia; Division of Infectious Diseases, Children's National Health System, Washington, District of Columbia; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Abstract
BACKGROUND: Congenital Zika infection can result in a spectrum of neurological abnormalities in the newborn. Newborns exposed to Zika virus in utero often have neuroimaging as part of their clinical evaluation. METHODS: Through the Congenital Zika Program at Children's National Health System in Washington DC, we performed fetal or neonatal neuroimaging, including magnetic resonance imaging and ultrasound, on over 70 fetuses or neonates with intrauterine Zika exposure. Novel findings on neonatal brain magnetic resonance imaging were observed in two instances. RESULTS: Gadolinium-contrast magnetic resonance imaging showed enhancement of multiple cranial nerves at three days of age on one infant. Another infant underwent magnetic resonance imaging at 16 days of age and was shown to have a chronic ischemic cerebral infarction. This infant had previously normal fetal magnetic resonance imaging. CONCLUSION: Cranial nerve enhancement and cerebral infarction may be among the expanding list of neurological findings in congenital Zika infection. Postnatal brain magnetic resonance imaging should be considered for newborns exposed to Zika virus in utero.
BACKGROUND:Congenital Zika infection can result in a spectrum of neurological abnormalities in the newborn. Newborns exposed to Zika virus in utero often have neuroimaging as part of their clinical evaluation. METHODS: Through the Congenital Zika Program at Children's National Health System in Washington DC, we performed fetal or neonatal neuroimaging, including magnetic resonance imaging and ultrasound, on over 70 fetuses or neonates with intrauterine Zika exposure. Novel findings on neonatal brain magnetic resonance imaging were observed in two instances. RESULTS:Gadolinium-contrast magnetic resonance imaging showed enhancement of multiple cranial nerves at three days of age on one infant. Another infant underwent magnetic resonance imaging at 16 days of age and was shown to have a chronic ischemic cerebral infarction. This infant had previously normal fetal magnetic resonance imaging. CONCLUSION: Cranial nerve enhancement and cerebral infarction may be among the expanding list of neurological findings in congenital Zika infection. Postnatal brain magnetic resonance imaging should be considered for newborns exposed to Zika virus in utero.
Authors: Sarah B Mulkey; Dorothy I Bulas; Gilbert Vezina; Yamil Fourzali; Armando Morales; Margarita Arroyave-Wessel; Christopher B Swisher; Caitlin Cristante; Stephanie M Russo; Liliana Encinales; Nelly Pacheco; Youssef A Kousa; Robert S Lanciotti; Carlos Cure; Roberta L DeBiasi; Adre J du Plessis Journal: JAMA Pediatr Date: 2019-01-01 Impact factor: 16.193
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