Congenital Zika Syndrome: The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals

Maria de Fatima Viana Vasco Aragão, Vanessa van der Linden, Natacha Calheiros Petribu, Marcelo Moraes Valenca, Paul M. Parizel, Roberto Jose Vieira de Mello

Research output: Contribution to journalReview article

Abstract

In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100%) and calcification of the caudate nuclei was noted in 66.7% of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3%); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7%), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.

Original languageEnglish
Pages (from-to)29-33
Number of pages5
JournalTopics in magnetic resonance imaging : TMRI
Volume28
Issue number1
DOIs
Publication statusPublished - 1 Feb 2019

Fingerprint

Arthrogryposis
Caudate Nucleus
Lateral Ventricles
Brain Stem
Cause of Death
Pia Mater
Tomography
Ependyma
Corpus Striatum
Subarachnoid Space
Gliosis
Brain
Deglutition Disorders
Cerebellum
Lung Diseases
Sepsis
Pneumonia
Neurons
Lung
Microcephaly with Simplified Gyral Pattern

Cite this

de Fatima Viana Vasco Aragão, Maria ; van der Linden, Vanessa ; Petribu, Natacha Calheiros ; Valenca, Marcelo Moraes ; Parizel, Paul M. ; de Mello, Roberto Jose Vieira. / Congenital Zika Syndrome : The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals. In: Topics in magnetic resonance imaging : TMRI. 2019 ; Vol. 28, No. 1. pp. 29-33.
@article{7b0c68798de4425cb76b9b0607431d3f,
title = "Congenital Zika Syndrome: The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals",
abstract = "In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100{\%}) and calcification of the caudate nuclei was noted in 66.7{\%} of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3{\%}); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7{\%}), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.",
author = "{de Fatima Viana Vasco Arag{\~a}o}, Maria and {van der Linden}, Vanessa and Petribu, {Natacha Calheiros} and Valenca, {Marcelo Moraes} and Parizel, {Paul M.} and {de Mello}, {Roberto Jose Vieira}",
year = "2019",
month = "2",
day = "1",
doi = "10.1097/RMR.0000000000000194",
language = "English",
volume = "28",
pages = "29--33",
journal = "Topics in magnetic resonance imaging : TMRI",
issn = "1536-1004",
publisher = "Lippincott Williams & Wilkins",
number = "1",

}

Congenital Zika Syndrome : The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals. / de Fatima Viana Vasco Aragão, Maria; van der Linden, Vanessa; Petribu, Natacha Calheiros; Valenca, Marcelo Moraes; Parizel, Paul M.; de Mello, Roberto Jose Vieira.

In: Topics in magnetic resonance imaging : TMRI, Vol. 28, No. 1, 01.02.2019, p. 29-33.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Congenital Zika Syndrome

T2 - The Main Cause of Death and Correspondence Between Brain CT and Postmortem Histological Section Findings From the Same Individuals

AU - de Fatima Viana Vasco Aragão, Maria

AU - van der Linden, Vanessa

AU - Petribu, Natacha Calheiros

AU - Valenca, Marcelo Moraes

AU - Parizel, Paul M.

AU - de Mello, Roberto Jose Vieira

PY - 2019/2/1

Y1 - 2019/2/1

N2 - In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100%) and calcification of the caudate nuclei was noted in 66.7% of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3%); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7%), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.

AB - In the present case series, the cause of death of infants diagnosed with congenital Zika syndrome (CZS) was lung disease (pneumonia and sepsis with massive pulmonary aspiration), probably secondary to dysphagia and reflux. The main findings in infants with a confirmed diagnosis of CZS who died were as follows: (1) calcification and hypoplasia of the lentiform nuclei, hypoplasia of the caudate nuclei, and calcification at the cortical-subcortical junction was noted in all cases (100%) and calcification of the caudate nuclei was noted in 66.7% of cases; (2) calcification in the brainstem and along the lateral wall of the lateral ventricles was noted in only the case with arthrogryposis (33.3%); and (3) lesions in the posterior fossa (hypoplasia of the brainstem and cerebellum) were noted in two cases (66.7%), including the case with arthrogryposis. The findings concerning calcifications and brain malformations obtained from non-contrast computed tomography (CT) demonstrated good agreement with findings obtained from the postmortem pathological analysis; however, CT failed to detect discontinuity of the pia mater with heterotopia, invasion of the cerebral tissue into the subarachnoid space, and discontinuity of the ependyma in the lateral ventricles with gliosis; this last feature was only imaged in the most severe case of extreme microcephaly with a simplified gyral pattern. Only histopathology showed grouped calcifications associated with scattered calcifications suggestive of the neuron morphology.

UR - http://www.scopus.com/inward/record.url?scp=85062421626&partnerID=8YFLogxK

U2 - 10.1097/RMR.0000000000000194

DO - 10.1097/RMR.0000000000000194

M3 - Review article

VL - 28

SP - 29

EP - 33

JO - Topics in magnetic resonance imaging : TMRI

JF - Topics in magnetic resonance imaging : TMRI

SN - 1536-1004

IS - 1

ER -