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1. Congenital cytomegalovirus infection

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Figure 16-1

Congenital cytomegalovirus infection.

CT images of 4 patients. A. Infant with ventriculomegaly and extensive periventricular calcification. B. Infant with schizencephaly and periventricular calcifications on the right and a shallow sylvian fissure on the left. C. Cerebellar hypoplasia and extensive cortical, basal ganglia, and periventricular calcifications in a 2-year-old child. D. 6-year-old child with small calcifications, cortical thickening, shallow sylvian fissures, and white matter hypoattenuation.

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2. Congenital cytomegalovirus infection

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Figure 16-2

Congenital cytomegalovirus infection.

There are multiple coarse echogenic foci of calcification adjacent to slightly dilated lateral ventricles on this coronal sonographic image of a 2-month-old infant with developmental delay.

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3. Congenital toxoplasmosis

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Figure 16-3

Congenital toxoplasmosis.

A CT image of a 2-year-old child with seizures and spastic diplegia due to congenital toxoplasmosis shows multiple white matter calcifications, mild ex vacuo ventriculomegaly, and white matter thinning.

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4. Herpes simplex encephalitis

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Figure 16-4

Herpes simplex encephalitis.

This 2-week-old infant presented with apnea, seizures, and a vesicular rash. HSV-2 was isolated from the CSF. A, B. Diffusion-weighted MR images show an area of edema on the left (arrow), most prominently involving the cortical gray matter. There are also multiple small foci of edema scattered elsewhere.

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5. Neonatal herpes virus encephalitis

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Figure 16-5

Neonatal herpes virus encephalitis.

A. An ADC image of a 2-week-old infant shows multiple areas of restricted diffusion in the right temporal lobe and right frontal lobe (arrow). There is also involvement of the internal capsule and central gray matter. B. A fluid attenuated inversion recovery (FLAIR) image obtained 20 days later shows developing cystic encephalomalacia in the right frontal lobe (arrow). C. There are multiple ill-defined areas of hyperintensity in the right cerebral white matter and central gray matter on this T2-weighted sequence. D. An unenhanced sagittal T1-weighted image shows hyperintensity of multiple gyri in the right cerebral hemisphere and subtle hypointensity in the right temporal lobe white matter. E. There is patchy enhancement in portions of the right cerebral white matter on this T1-weighted image obtained after intravenous gadolinium administration. The images in B to E were obtained 22 days after the initial clinical presentation.

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