Congenital Zika syndrome (CZS) represents a severe neurodevelopmental disorder resulting from prenatal Zika virus (ZIKV) infection, particularly when maternal exposure occurs during the first trimester. The clinical spectrum includes microcephaly, cerebral calcifications, ventriculomegaly, cortical malformations, and profound neurological deficits. This case study presents a comprehensive overview of neuroimaging findings throughout the prenatal and postnatal periods, along with long-term clinical outcomes in a child diagnosed with CZS following maternal ZIKV infection during early pregnancy.
The mother, a 33-year-old primigravida, experienced fever and cutaneous rash at 7 weeks of gestation—symptoms consistent with acute ZIKV infection. Prenatal ultrasound at 20 weeks revealed head circumference below the 5th percentile and borderline bilateral ventriculomegaly (13 mm), prompting further evaluation. At 37 weeks, fetal MRI confirmed severe microcephaly with head circumference less than the 3rd percentile, smooth brain surface, and mild bilateral hydrocephalus. Ultrasound also identified periventricular hyperechogenicity and intracranial calcifications, suggesting active neuronal injury. Posterior fossa structures remained normal, ruling out posterior fossa cysts or cerebellar hypoplasia. These imaging features are characteristic of fetal brain disruption sequence, a pattern seen in severe congenital infections.168555-66-6 medchemexpress
Following delivery at 39 weeks, the newborn exhibited microcephaly (head circumference: 29 cm), low birth weight (2,450 g), and normal Apgar scores. Brain CT performed at 25 days of life revealed extensive parenchymal atrophy, widespread cerebral calcifications predominantly located in the subcortical white matter and periventricular regions, and marked ventricular dilatation.50-35-1 site These findings were consistent with irreversible brain damage due to viral-induced necrosis and impaired neuronal migration. Over time, follow-up imaging showed progressive ventriculomegaly, confirming secondary hydrocephalus requiring ventriculoperitoneal shunt placement.
At six years of age, the child continues to experience severe neurological impairments, including intractable seizures managed with antiepileptic drugs, significant developmental delay, visual and auditory deficits, and motor dysfunction. Despite no overt signs of microcephaly at birth in some cases, neuroimaging remains essential for early detection of underlying pathology. The persistence of cerebral calcifications and ventricular enlargement even after one year suggests that early postnatal imaging is critical for accurate diagnosis and timely intervention.PMID:30855842
This case underscores the importance of serial neuroimaging in monitoring infants suspected of CZS. While microcephaly is a hallmark feature, its absence does not exclude CZS, as some children present with nonmicrocephalic forms of the syndrome. Advanced imaging techniques such as MRI provide superior resolution for detecting subtle cortical abnormalities, including lissencephaly, pachygyria, polymicrogyria, and heterotopia. Ophthalmic involvement, including optic nerve hypoplasia and retinal mottling, was also observed, highlighting the multisystem nature of CZS.
Long-term follow-up reveals that children with CZS face lifelong challenges, regardless of initial presentation. Early diagnosis through prenatal imaging and placental histology enables timely interventions, including neurodevelopmental support and seizure management. As ZIKV remains endemic in tropical regions, ongoing surveillance, public health education, and research into preventive strategies are vital to reduce the burden of this devastating condition.MedChemExpress (MCE) offers a wide range of high-quality research chemicals and biochemicals (novel life-science reagents, reference compounds and natural compounds) for scientific use. We have professionally experienced and friendly staff to meet your needs. We are a competent and trustworthy partner for your research and scientific projects.Related websites: https://www.medchemexpress.com
