Microcephaly and Zika virus: neonatal neuroradiological aspects.

PURPOSE: The aim of this study is to describe some radiological features in the newborns with microcephaly caused by Zika virus infection during pregnancy. METHODS: We radiologically analyzed 13 cases of newborns with microcephaly born to mothers who were infected by the Zika virus in the early stage of pregnancy. RESULTS: The most frequently observed radiological findings were microcephaly and decreased brain parenchymal volume associated with lissencephaly, ventriculomegaly secondary to the lack of brain tissue (not hypertensive), and coarse and anarchic calcifications mainly involving the subcortical cortical transition, and the basal ganglia. CONCLUSIONS: Although it cannot be concluded that there is a definitive pathognomonic radiographic pattern of microcephaly caused by Zika virus, gross calcifications and anarchic distribution involving the subcortical cortical transition and the basal ganglia, in association with lissencephaly and in the absence of hypertensive ventriculomegaly, are characteristic of this type of infection.

Transorbital penetrating wound to contralateral hemisphere: case report / Ferimento penetrante transorbital com lesão no hemisfério contralateral: relato de caso

There are few reports in the literature of transorbital penetration brain damage. We reported a transorbital craniocerebral injury caused by a barbecue skewer in a child in the context of domestic-accident. A 7-year-old male child accidentally fell and a barbecue skewer penetrated his right orbit. The object was pulled out immediately by the boy?s father. On admission, he demonstrated disproportioned right hemiparesis and Axial CT images showed no evidence of fracture of orbital wall on the right side and a small hematoma and traumatic subarachnoid hemorrhage on the left hemisphere. Surgery was not indicated, antibiotics were administered for 14 days, his neurological impairment recovered completely on seven days. On the 12th post-admission day, a CT was done which showed no hematoma. At the time of discharge, the boy was alert without any physical sequelae or complication. Children are frequently harmed during play and are mainly jeopardized by accidents at home, and it is necessary more governmental investment to objectively lowering penetrating wounds to the head in children and divulgated for general population that foreign body penetrating the intracranial cavity must be removed only during surgery.

Existem na literatura poucos relatos de traumatismo cranioencefálico causados por penetração transorbital. Será descrito o caso de uma criança do sexo masculino, de 7 anos de idade, que caiu acidentalmente em casa e um espeto de churrasco penetrou na sua órbita direita. O objeto foi imediatamente retirado pelo pai. Na admissão ao Hospital, a criança apresentava-se com hemiparesia direita desproporcionada e na tomografia de crânio evidenciavam-se contusão cerebral e hemorragia subaracnoide traumática no hemisfério esquerdo, entretanto não havia sinais de fraturas. Não foi necessário procedimento cirúrgico, e o menor permaneceu internado para administração de antibióticos por 14 dias, obtendo melhora do déficit após sete dias do internamento. Com 12 dias de hospitalização, foi realizada nova tomografia, sem evidências de hematomas. Na alta, ele encontrava-se ativo, alerta e sem déficits motores. Crianças são frequentemente feridas durante jogos e brincadeiras, e esses acidentes acontecem principalmente no ambiente doméstico. Torna-se necessário maior investimento governamental para diminuir ferimentos penetrantes em crianças e divulgação, para a população em geral, sobre acidentes com penetração craniana, que devem ser encaminhados imediatamente ao hospital, devendo os objetos ser removidos somente durante o procedimento cirúrgico.