New cerebral findings in infants with congenital Zika syndrome

Since the first outbreak of Zika virus infection in Uganda in 1947, the world has dealt with sporadic repeated outbreaks. But the most recent one in Brazil in 2015 was different. It appeared to be associated with an increased incidence of microcephaly among infants born to mothers infected with the virus during gestation, especially during the first trimester.1

A series of seminal research papers convincingly correlated the presence of microcephaly with congenital Zika virus infection.1234 The authors all described subcortical calcifications; abnormal development of central nervous system neurons, cortex, and white matter; and associated ventriculomegaly in affected infants. These findings were identified by both histopathological analyses2 and non-invasive neuroimaging.35

In this issue, Aragao and colleagues (doi:10.1136/bmj.j4188) report new and important findings in the central nervous system on follow-up computed tomography (CT) scans from a series of 37 infants with confirmed or probable congenital Zika syndrome.6 Comparison of scans done soon after birth …