Congenital cytomegalovirus infection and brain anomalies

The spectrum of brain anomalies caused by cytomegalovirus (CMV) infection is discussed. Seven patients (four girls, three boys, ages ranging from 2 to 14 months) are included in this study. In the children and mothers serologic tests studied for CMV infection including IgG and IgM titres, and viral cultures for inclusion bodies, were positive. Cranial CT and MR imaging studies were performed. In all the patients, periventricular calcifications were evident on CT scans. CT and MR imaging revealed three patients with neuronal migrational disorders (pachygyria (n=2), and schizencephaly (n=1)). One patient had hydranencephaly. Of particular note, there were two patients with rhombencephalosynapsis, and one with Joubert's syndrome. CMV infection is known to cause some of the disorders of neuronal migration and organization in early gestation, and some encephaloclastic lesions (e.g. hydranencephaly) in late gestation. Its possible association with relatively rare cerebellar malformations (Joubert's syndrome, and rhombencephalosynapsis) as noted in this study, indicates further clinicoradiologic studies.