P183 – 2406: Specific features of cerebral lesions in small premature infants at cytomegalovirus infection

Abstract

Objective Study of specific features of CNS lesions in small premature infants at cytomegalovirus infection (CMVI). Methods Clinical-paraclinical (laboratory tests, neurosonography – NSG, brain MRI) examination of 518 infants with cytomegalovirus infection (CMVI) was performed. 197 children was born with extremely low birth weight and 221children – with very low birth weight (ELBW and VLBW). Results During first 7 days of life depression syndrome was observed in 85% of children with ELBW and in 69% – with VLBW: apnoe attacks, seizures, hard disorders of muscular tonus and spontaneous movement activity, absence of oral and spinal inborn reflexes, hypertensive and vegetovisceral and seizure syndromes were noted. NSG revealed echogenicity increase in periventricular area in 89% of children with ELBW and 74% – with VLBW; the necessity to differentiate manifestation of periventricular edema (PVE) with periventricular leukomalacia occurred. More often increased echogenicity of periventricular areas was observed in 94% of children with ELBW (76% – with VLBW). Hyperechoic inclusions in the brain parenchyma varied from single to multiple (picture of starry sky); often they were found in optic thalamus areas. Rarer gliosis of striatal vessels like crows feet which clinically manifested by syndrome of increased nervous-reflectory irritability. Hyperechoic inclusions in the brain parenchyma contained mineralized vasculopathy in the basal ganglia area were observed in 89% of children with ELBW and 74% – with VLBW. Pathologic neurosonographic signs in the isolated form were rare. Character of structural lesions was also confirmed by brain MRI; hyperechoic inclusions combined with PVE in 61% and 48% of children correspondingly; rarer they combined with ventriculomegaly, concomitant periventricular hemorrhage. Conclusion Neurosenography is available highly sensitive screening diagnostic method for determination of severe lesions of immature brain structures in small premature infants with CMVI.