Neonate with sensorineural hearing loss + microcephaly, suspected congenital CMV
Recommended: MRI Brain + Head Ultrasound + Urine CMV PCR is the preferred imaging study for neonate with sensorineural hearing loss + microcephaly, suspected congenital cmv. Periventricular calcifications, polymicrogyria, ventriculomegaly.
Recommended study
MRI Brain + Head Ultrasound + Urine CMV PCR
Periventricular calcifications, polymicrogyria, ventriculomegaly. Urine CMV PCR within 21 days establishes congenital infection.
If the default doesn't apply
Audiology follow-up
Serial auditory brainstem response (ABR)
No contrast
Watch-outs
Periventricular calcifications
Differential: TORCH infections, tuberous sclerosis. CMV is most common congenital infection.
Antiviral therapy
Valganciclovir for symptomatic congenital CMV — improves hearing outcomes.
Pearls
- Head ultrasound: hyperechoic periventricular foci (calcifications), germinolytic cysts.
- MRI: cortical malformations (polymicrogyria), cerebellar hypoplasia, ventriculomegaly.
- Congenital CMV is most common congenital infection in developed world.