Brain Magnetic Resonance Imaging in Congenital Cytomegalovirus With Failed Newborn Hearing Screen

In 2013, Utah enacted legislation requiring that infants failing newborn hearing screening be tested for cytomegalovirus infection. As a result, cytomegalovirus-infected infants are being identified because of hearing deficits. The neuroimaging findings in this population have not been characterized...

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Bibliographic Details
Published in:	Pediatric neurology 2020-09, Vol.110, p.55-58
Main Authors:	Hranilovich, Jennifer A., Park, Albert H., Knackstedt, Elizabeth D., Ostrander, Betsy E., Hedlund, Gary L., Shi, Kevin, Bale, James F.
Format:	Article
Language:	eng
Subjects:	Auditory brainstem response Brain Diseases - diagnostic imaging Brain Diseases - etiology Brain magnetic resonance imaging Brain MRI Congenital CMV Congenital cytomegalovirus infection Cytomegalovirus Infections - complications Cytomegalovirus Infections - congenital Cytomegalovirus Infections - diagnostic imaging Evoked Potentials, Auditory, Brain Stem - physiology Female Hearing loss Hearing Loss - diagnosis Hearing Loss - etiology Hearing Tests Humans Infant Infant, Newborn Infant, Newborn, Diseases Magnetic Resonance Imaging Male Neonatal Screening Neuroimaging Newborn hearing screen Retrospective Studies White Matter - diagnostic imaging White Matter - pathology White matter lesions
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Summary:	In 2013, Utah enacted legislation requiring that infants failing newborn hearing screening be tested for cytomegalovirus infection. As a result, cytomegalovirus-infected infants are being identified because of hearing deficits. The neuroimaging findings in this population have not been characterized. Retrospective medical record review was used to identify patients seen at the University of Utah and Primary Children’s Hospitals in Salt Lake City, Utah, who failed newborn hearing screening. A cohort of patients with congenital cytomegalovirus infection, brain magnetic resonance imaging (MRI), and sedated auditory brainstem response testing was studied. Seventeen patients were identified; 11 (65%) were female. Confirmatory auditory brainstem response testing, performed at a median age 29 days, showed profound hearing loss in 8 (47%) subjects, severe loss in two (12%), moderate loss in two (12%), and mild loss in three (18%); two (12%) subjects had normal hearing. The diagnosis of cytomegalovirus infection was made at a median age 23 days. Brain imaging was performed at a median age 65 days. Ten (59%) subjects had one or more neuroimaging abnormality. White matter lesions were found in eight (47%) subjects, cysts in three (18%), and stroke in two (12%). Polymicrogyria was identified in two (12%) subjects. Seven (41%) subjects had normal brain MRIs. These results indicate that most infants whose cytomegalovirus infections were identified after failing newborn hearing screening had abnormal brain MRIs. Our results suggest that brain MRIs should be considered in infants with congenital cytomegalovirus infections who are identified through hearing screening programs.
ISSN:	0887-8994 1873-5150