Frequency of linear hyperechogenicity over the basal ganglia in young infants with congenital rubella syndrome

Five young infants with congenital rubella syndrome (CRS) underwent cranial ultrasonographic examinations and/or computed tomographic examinations. Only two of these infants were small for their gestational age, and none of them were microcephalic at birth. Deafness and ocular lesions were found in four patients, and congenital heart disease was found in three. All had abnormal ultrasonographic findings: linear-shaped hyperechogenicity over the basal ganglia was noted for five patients, periventricular punctate hyperechogenicity was noted for three, and subependymal cysts were observed in two. Follow-up ultrasonograms for two of the patients showed progressively enlarging hyperechogenic lesions. Calcification was found in both patients examined by means of computed tomography. All patients became microcephalic, with profound global developmental delay. Intracranial calcifications are common findings in patients with CRS. Ultrasonography should be performed for high-risk neonates, regardless of their symptoms. The finding of linear hyperechogenicity over the basal ganglia should prompt a search for all congenital infections, including CRS.