Brain damage in Zika babies may extend far beyond microcephaly, study suggests

Much of the public alarm about Zika has focused on the dramatic, heart-breaking pictures of children with a condition known as microcephaly characterised by an abnormally small head.

But a paper published Tuesday from the epicentre of the epidemic in northeastern Brazil shows that the damage to a baby’s brain may be far more extensive and diverse than has been previously known.

While there have been sporadic case studies about fetal abnormalities beyond microcephaly, this is the first to provide a comprehensive breakdown of the type of defects that radiologists are seeing in the womb and after babies are born.

In a series of striking images in the journal Radiology, researchers detail a half-dozen brain defects that they found in nearly all the babies in their study. This is significant because, technically speaking, microcephaly is a superficial diagnosis that is based on the how a child’s head circumference compares to others. Some children with the condition go on to develop normally or have only minimal delays. This study confirms fears that the babies with Zika may be more severely impacted.

“What this tells you is that Zika is a devastating infection. There is evidence the brain just didn’t form normally,” Deborah Levine, a professor of radiology at Harvard Medical School and a study co-author, said in an interview.

The research involved 45 children, including one set of twins, who were referred to the Instituto de Pesquisa in Campina Grande in the state of Paraiba from June 2015 to May 2016. Most of them had a head circumference below the 5th percentile and were confirmed or presumed to have been infected with Zika while in utero. Researchers used magnetic resonance or other imaging technology to track their development over time.