Child's Nervous System

, Volume 34, Issue 5, pp 957–963 | Cite as

Neuroimaging findings associated with congenital Zika virus syndrome: case series at the time of first epidemic outbreak in Pernambuco State, Brazil

  • Pedro Pires
  • Patricia Jungmann
  • Jully Moura Galvão
  • Adriano Hazin
  • Luiza Menezes
  • Ricardo Ximenes
  • Gabriele Tonni
  • Edward Araujo Júnior
Original Paper



This study aimed to describe the prenatal and postnatal neuroimaging and clinical findings in a clinical series following congenital Zika virus syndrome during the first epidemic Zika virus (ZIKV) outbreak in the State of Pernambuco, Brazil.


We (the authors) conducted a retrospective study of a prospectively collected case series of fetuses and neonates with microcephaly born to mothers with presumed/confirmed congenital ZIKV syndrome. Prenatal ultrasound findings were reviewed to identify potential central nervous system (CNS) abnormalities. Neonates underwent postnatal neuroimaging follow up by computed tomography (CT)-scan or magnetic resonance (MR) imaging.


The prenatal and postnatal outcomes of eight fetuses/neonates born to mothers with presumed/confirmed congenital ZIKV syndrome were examined. The mean gestational age at ultrasound was 31.3 weeks. Severe microcephaly was identified in seven fetuses (87.5%), while ventriculomegaly and brain calcifications were detected in all fetuses. The mean gestational age at delivery and head circumference were 38 weeks and 30.2 cm, respectively. All cases of microcephaly but one was confirmed postnatally. Brain CT scans or MRIs were performed in seven newborns, and all had periventricular and/or parenchymal calcifications, symmetrical or asymmetrical ventriculomegaly, pachygyria, and reduced sulcation and gyration. MR imaging aided the detection of one undetected case of corpus callosum dysgenesis and was essential in documenting reduced mantel of the cerebral cortex and reduced gyration and sulcation, especially involving the parietal lobe. In addition, MR imaging was also able to display irregular interfaces with the subcortical white matter, a finding consistent with polymicrogyria, more frequently seen at the level of the frontal lobe and atrophic and thinned pons.


Severe microcephaly and CNS abnormalities may be associated with congenital ZIKV syndrome.


Congenital Zika virus syndrome Microcephaly Brain abnormalities Ultrasound Computed tomography Magnetic resonance imaging 


Compliance with ethical standards

Conflict of interest

We Pedro PIRES, Patricia JUNGMANN, Jully Moura GALVÃO, Adriano HAZIN, Luiza MENEZES, Ricardo XIMENES, Gabriele TONNI, and Edward ARAUJO JÚNIOR hereby declare that all authors have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Maternal and ChildPernambuco University (UPE)RecifeBrazil
  2. 2.Department of PathologyPernambuco University (UPE)RecifeBrazil
  3. 3.Department of RadiologyInstituto de Medicina Integral Professor Fernandes Figueira (IMIP)RecifeBrazil
  4. 4.Department of Tropical MedicineFederal University of Pernambuco (UFPE)RecifeBrazil
  5. 5.Department of Obstetrics and Gynecology, AUSL Reggio EmiliaGuastalla Civil HospitalReggio EmiliaItaly
  6. 6.Department of Obstetrics, Paulista School of MedicineFederal University of São Paulo (EPM-UNIFESP)São PauloBrazil

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