Radiological characterization of cerebral phenotype in newborn microcephaly cases from 2015 outbreak in Brazil

Brazil is facing, since October of 2015, an outbreak of microcephalic fetuses. This outbreak is correlated with the beginning of circulation of Zika virus (ZIKV) in the country. Although it is clear that the size of the head is diminished in these fetuses, the brain phenotype associated with these malformations is unknown. We collected computed tomography images of the microcephaly cases from the region of Natal, Rio Grande do Norte, from September 2015 to February 2016. The CT acquisition was performed by a multidetector equipment, Philips Brilliance 64 (Philips Medical Systems; Cleveland, EUA), with tomographic section thickness of 1.0 mm, without administration of iodinated contrast. The protocol for this study was reviewed and approved by the Universidade Federal do Rio Grande do Norte Ethics Committee, certificate of approval CAAE 53111416.7.0000.5537. Role of funding source: The funding agencies had no participation in this work. The microcephalies derived from the current outbreak are associated with intracerebral calcifications, malformation of the ventricular system, migratory disorders in the telencephalon and, in a lower frequency, malformation of the cerebellum and brainstem. The characteristics here described are not usually found in other types of microcephaly. We suggest that this work can be used as a guideline to identify microcephaly cases associated to the current outbreak.