Developmental Disabilities and Intracranial Abnormalities in Children with Symptomatic Cytomegalovirus and Cochlear Implants

Objective . To examine the association of intracranial radiographic abnormalities and developmental measures with outcomes in children with congenital symptomatic cytomegalovirus (CMV) and cochlear implants (CI). Design/Methods . It was a retrospective review of 15 children implanted from 2004 to 2010. Preimplant nonverbal intelligence quotient/developmental quotient (IQ/DQ) and head circumference (HC) were obtained. Computed tomography and magnetic resonance imaging of the brain and post-CI audiometry and language assessments were reviewed. Results . Eleven children (73%) had cognitive delay. Most had >1 developmental disability. Median IQ/DQ was 65 (23–90). All had imaging abnormalities. Most imaging abnormalities were in parietal (60%) and temporal (60%) lobes. Children with HC < 5th percentile had poorer median post-CI PTA (38 dB versus 27 dB, P = 0.02). Periventricular calcifications were associated with lower receptive ( r b = −0.75, P = 0.03) and expressive ( r b = −0.84, P = 0.008) language. Because IQ/DQ was associated with periventricular calcifications ( r b = −0.53, P = 0.04) and small HC ( r b = −0.73, P = 0.002), their relationships with language appear partially driven by IQ/DQ. Conclusions . The location of brain abnormalities appears to correlate with worse outcomes after CI. These findings may allow for more accurate counseling of parents regarding anticipated postimplantation performance.