Cytomegalovirus

            Cytomegalovirus (CMV) is a member of the herpesvirus family, which subclinically infects nearly all the population at some time in their life and is the most frequent cause of a congenital viral infection. Congenital infection occurs after primary or secondary (reactivation) maternal infection, and the virus reaches the fetus via the transplacental route. CNS involvement is a very important manifestation of the disease, and as with toxoplasmosis, earlier infection results in poorer outcome with more severe and persistent neurologic sequelae.

            CMV produces a diffuse encephalitic infectious process, which results in multifocal destructive changes in the brain that lead to calcifications and microcephaly. The immature cells in the germinal matrix region are the first involved areas in the brain. Necrosis and calcifications of those areas explain the predilection for thick or nodular calcifications in the periventricular area. Intracranial calcifications may also be found in the cortical and subcortical region, as well as in the basal ganglia, so differentiation between congenital infection from CMV or toxoplasmosis is not certain based on imaging criteria alone. Endnote

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