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Child's Nervous System

, Volume 34, Issue 1, pp 101–106 | Cite as

Hydrocephalus associated to congenital Zika syndrome: does shunting improve clinical features?

  • Eduardo JucáEmail author
  • André Pessoa
  • Erlane Ribeiro
  • Rafaela Menezes
  • Saile Kerbage
  • Thayse Lopes
  • Luciano Pamplona Cavalcanti
Focus Session

Abstract

Purpose

Congenital Zika syndrome (CZS) is a new entity with little information about its course and natural history. It is known that prenatal infection by Zika virus is associated to disrupted nervous system development, leading to typical neurological disabilities and deformities. Some children present progressive ventriculomegaly and hydrocephalus associated to aggravation of seizures and neurological impairment. The aim of this study is to evaluate the development of hydrocephalus and the impact of ventriculoperitoneal shunt insertion in the clinical condition of these children.

Methods

Data was obtained from chart review, direct interviews with patients’ parents, direct neurological examination, and analysis of pre- and postoperative neuroimages.

Results

A group of 115 patients had CZS diagnosis from November 2015 to July 2017. Among them, 21 (18.3%) patients had ventricular enlargement noted on follow-up CT scans. Six children (28.6%) underwent a ventriculoperitoneal shunt and all had some improvement after surgery concerning either waking time during the day and better interaction. Overall improvement was also noted in seizures. Spasticity decrease and more cervical control were also achieved. In two out of six cases, a slight increase in parenchymal length could be noted on the CT scans.

Conclusion

This series points out the possibility of hypertensive hydrocephalus development in CZS patients. Affected children may benefit from VP shunt insertion. These findings suggest a dual pathology association: fetal brain disruption and primary cortical malformation by the virus itself and hypertensive hydrocephalus. This is already seen in some cases of congenital rubella, toxoplasmosis, or cytomegalovirus-associated hydrocephalus.

Keywords

Zika virus Microcephaly Hydrocephalus Ventriculoperitoneal shunt 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that there is no conflict of interests to be disclosed.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Eduardo Jucá
    • 1
    • 2
    • 3
    Email author
  • André Pessoa
    • 2
    • 4
  • Erlane Ribeiro
    • 2
    • 3
  • Rafaela Menezes
    • 3
  • Saile Kerbage
    • 2
  • Thayse Lopes
    • 3
  • Luciano Pamplona Cavalcanti
    • 5
  1. 1.Universidade de Fortaleza (UNIFOR)FortalezaBrazil
  2. 2.Hospital Infantil Albert SabinFortalezaBrazil
  3. 3.Centro Universitário ChristusFortalezaBrazil
  4. 4.Universidade Estadual do Ceará-UECEFortalezaBrazil
  5. 5.Universidade Federal do CearáFortalezaBrazil

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