28. I. Congenital/Neonatal Infections
Herpes Simplex
Pathology:
- Type 2 in 90%.
- Neonatal infection.
- Diffuse brain involvement.
- Predilection to the endothelial lining of vessels.
- No predilection to limbic system.
29. I. Congenital/Neonatal Infections
Herpes Simplex
Clinical:
- Infants with HSV develop symptoms in the first
week of life and typically present at 10-17 days.
- Newborns tend to present with 3 patterns, as follows:
• Category 1: The disease is
limited to the skin, mouth, and
eyes.
• Category 2: Primary CNS
involvement is present.
• Category 3: Disseminated
disease involving the CNS, lung,
liver, skin, and eyes is observed.
31. I. Congenital/Neonatal Infections
Herpes Simplex
II. CT:
- In acute infections, focal or diffuse white matter lucency
with accentuated relative
hyperdensity of the grey matter. Hemorrhagic infarctions
may occur.
- Involvement is in the periventricular white matter,
sparing the medial temporal and inferior frontal lobes.
- In addition, meningeal enhancement may be observed
following contrast.
32. I. Congenital/Neonatal Infections
Herpes Simplex
III. MRI:
- In neonates, Hypointense T1/
Hyperintense T2 lesions in the
periventricular white matter, with
the medial temporal and inferior
frontal lobes spared.