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Cytomegalovirus (CMV) infection (neonatal)

Infectious diseases
Pediatric diseases

General description

Neonatal cytomegalovirus (CMV) infection is the most common congenital infection. It occurs transplacentally due to primary maternal CMV infection or reactivation of latent infection during pregnancy.

CMV has a predilection for neural tissue, spreading hematogenously to the choroid plexus, ependyma, germinal matrix, and capillary endothelium. Infection of the germinal matrix can disrupt neuronal migration, while infection of the vascular endothelium can lead to ischemic changes.

Neurological symptoms in the neonatal period can include seizures, chorioretinitis, microcephaly, and hearing loss. Some neonates with asymptomatic infection may develop delayed-onset hearing loss.

Subependymal and basal ganglia calcification

Non-SOL
  • Cerebrum
    Cerebral white matter
    Periventricular white matter
  • Ventricle
    Ependyma
  • Caudate nucleus
  • Putamen
  • Globus pallidus
Bilateral
Multiple
Linear
Punctate
Plain CT
Calcified attenuation
T2*WI
Hypointensity
SWI
Hypointensity

The classic pattern of CNS injury associated with neonatal CMV infection is characterized by subependymal/periventricular and basal ganglia calcifications.

Malformations

Non-SOL
  • Cerebrum
Morphology
Microcephaly
Lissencephaly
Polymicrogyria
Schizencephaly

Neonatal CMV infection can result in a range of brain abnormalities, including malformations of cortical development such as lissencephaly, pachygyria, polymicrogyria, and schizencephaly, as well as microcephaly. Among these, polymicrogyria is the most frequently observed cortical malformation.

White matter lesion

Non-SOL
  • Cerebrum
    Cerebral white matter
T2WI
Hyperintensity
FLAIR
Hyperintensity