Zika virus infection: A correlation between prenatal ultrasonographic and postmortem neuropathologic changes. Issue 6 (11th November 2019)

• Record Type: Journal Article
• Authors: Gutiérrez Sánchez, Luz A.; Sandoval Martínez, Diana K.; Díaz‐Martínez, Luis A.; Becerra Mojica, Carlos H.
• Is Part Of: Neuropathology. Volume 39:Issue 6(2019)
• Page Start: 434
• Page End: 440
• Publication Date: 2019-11-11
• Subjects: arthrogryposis -- corpus callosum dysgenesis -- lissencephaly -- microcephaly -- Zika virus infection; Nervous system -- Diseases -- Periodicals; Nervous system -- Pathophysiology -- Periodicals; 616.8047
• DOI: 10.1111/neup.12603
• Languages: English
• ISSNs: 0919-6544

Abstract

Abstract : This study presents a correlation between prenatal ultrasonographic images and neuropathologic findings of postmortem tissue samples from five confirmed cases of perinatal Zika virus (ZIKV) infection belonging to the cohort of the ZEN Initiative in Bucaramanga, Colombia. Deaths occurred between June 2016 and March 2017. Mothers consulted with ZIKV infection clinical manifestations or fetal central nervous system (CNS) abnormalities or both. A detailed ultrasound scan and neurosonographic protocol was performed by maternal fetal specialists. Perinatal autopsies were performed following the Colombian National Health Institute's ZIKV protocol. The autopsies were from two fetal deaths, and three early neonatal deaths. Gestational age was between 26 2/7 and 38 2/7 weeks. Two cases were classified as mild microcephaly. Few findings by ultrasound and pathology were found in case 1 because it was a late infection; the other cases presented findings corresponding to congenital Zika syndrome: craniofacial malformations, cerebellar hypoplasia, anomalies of the corpus callosum and ventriculomegaly, all confirmed in autopsy specimens. By ultrasonography, hyperechogenicities were seen in several brain structures, which correspond to cortical and periventricular calcifications, subependymal glial reactivity and perivascular rings. The ultrasound and pathological findings show a wide spectrum of CNS anomalies that confirm the neurotropic effect of the ZIKV, recognizing the neuroimaging findings of this disease (unilateral ventriculomegaly, alterations in the corpus callosum and cerebellum, and calcifications) are highly suggestive of ZIKV infection.