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Comparison of brain MRI findings between microcephalic and normocephalic infants with congenital Zika syndrome
MRI FindingsMicrocephalyWithout Microcephaly (n = 3)P1P2P3P4
At Birth (n = 9)Postnatally (n = 7)
Reduced brain volume8 (88.9%)5 (71.4%)0 (0.0%).018a.550.141.021a
Brain stem hypoplasia6 (66.7%)1 (14.3%)0 (0.0%).182.060.020a.263
Cerebellum hypoplasia3 (33.3%)0 (0.0%)0 (0.0%).509.213.0871.000
Malformations of cortical developmentb
    Simplified gyral pattern6 (66.7%)0 (0.0%)0 (0.0%).182.028a.009a.515
    Pachygyria6 (66.7%)4 (66.7%)0 (0.0%).1821.000.637.069
    Polymicrogyria0 (0.0%)4 (66.7%)2 (66.7%).045a.011a.009a.245
    Normal cortex1 (11.1%)0 (0.0%)1 (33.3%).4551.0001.000.314
Brain calcifications
    Cortico-subcortical white matter junction8 (88.9%)7 (100.0%)3 (100.0%)1.0001.000.4741.000
    Calcifications at other sites7 (77.8%)0 (0.0%)0 (0.0%).046a.003a.001a.263
        Basal ganglia4 (44.4%)0 (0.0%)0 (0.0%).491.103.0821.000
        Thalamus3 (33.3%)0 (0.0%)0 (0.0%).509.229.2061.000
        Periventricular3 (33.3%)0 (0.0%)0 (0.0%).509.229.2061.000
        Brain stem4 (44.4%)0 (0.0%)0 (0.0%).491.103.0821.000
        Cerebellum2 (22.2%)0 (0.0%)0 (0.0%)1.000.475.4711.000
Corpus callosum abnormalities9 (100.0%)2 (28.6%)0 (0.0%).005a.005a.001a.058
Moderate-to-severe ventriculomegaly8 (88.9%)2 (28.6%)0 (0.0%).018a.035a.005a.087
Enlarged extra-axial CSF space9 (100.0%)3 (42.9%)0 (0.0%).005a.019a.003a.036a
Enlarged cisterna magna9 (100.0%)4 (57.1%)0 (0.0%).005a.063.008a.021a
Delayed myelinationb7 (77.8%)2 (33.3%)2 (66.7%)1.000.136.3351.000
Symmetry of abnormalities8 (88.9%)3 (42.9%)1 (33.3%).127.106.057.523
  • Note:—P indicates Fisher exact test; P1, microcephaly at birth vs without microcephaly; P2, microcephaly at birth vs microcephaly postnatally; P3, microcephaly at birth vs without microcephaly at birth (microcephaly postnatally + without microcephaly); P4, microcephaly (microcephaly at birth + microcephaly postnatally) vs without microcephaly. Microcephaly postnatally vs without microcephaly yielded no statistically significant results.
  • ↵a Statistically significant results.
  • ↵b Not assessed in Infant 14 (without MRI). For myelination assessment, infant 15 was considered born at term.