Microcephaly in infants , Ceará State , Brazil , 2015-2016 Microcefalia em recém-nascidos , Ceará , Brasil , 2015-2016

Microcefalia em recém-nascidos, Ceará, Brasil, 2015-2016 Luciano Pamplona de Góes Cavalcanti. Erlane Marques Ribeiro. André Luis Santos Pessoa. Francisco Herlânio Costa Carvalho. Manoel Martins Neto. Fernanda Montenegro de Carvalho Araújo. Carlos Henrique Alencar. Daniele Rocha Queiroz Lemos. Thayse Elaine Costa Figueiredo. Rhaquel de Morais Alves Barbosa Oliveira. Francisca Kalline de Almeida Barreto. Jorg Heukelbach.


THE STUDY
Brazil.June Authority (SESA-CE) (Graphic 1 under the public health authority of Ceará, Brazil. According to World Health Organization (WHO) and Ministry of Health of Brazil (MS), microcephaly is characterized by the measurement of the skull performed at least 24 hours 23 hours), using standard equipment 9,10 Newborn with microcephaly measurement of cephalic perimeter less than -2 standard measurement of cephalic perimeter less than or equal to 31.5 cm for girls and 31.9 for boys, equivalent to less than -2 standard deviations for the age of the neonate and sex.measurement of smaller head circumference than or equal to -2 standard deviations for gestational age and sex, according to  indicates a considerable increase as compared to previous years.From 127.549 births annually (Table 1).In contrast, in 2015, there cases of genetic abnormalities (Table 1).The prevalence and to 3.22 in January and February of 2016 (Table 1).features may accompany this picture, especially in severe cases as the excess of skin on the scalp, forming folds that in severe cases is palpable.On the face there may be excess upper lip and retromicrognatia.The short neck and an excess of skin in the neck are often reported in our casuistry.We also After the neurological physical examination our cases are characterized by neurological abnormalities noted since decreased strength and spastic hypertonia in the limbs.Joint contractures and some cases of arthrogryposis are also  knees and ankles, but also to a lesser degree on the shoulders, lead to death from aspiration pneumonia.dilatations ex-vacuum and subarachnoid space.It has also characterized by excessive number of small turns separated Was also found encashment of the sutures of the posterior bones of the skull.quarter, as reported by Oliveira. 11Among symptomatic microcephaly -light (head circumference 2 to 3 standard (smaller head circumference than 3 standard deviations periventricular or parenchymal and cerebellum; Intraocular ventricles, enlargement of the posterior fossa and increased subarachnoid space (Figure 3).  the neurological clinical spectrum ranged from normal decreased strength and stiffness in spastic limbs; extrapyramidal signs as appendicular dystonia rest and action Despite the severe brain damage found in the majority of patients evaluated, the incidence of convulsions has been changes.could be found in the basal ganglia and periventricular.These (Figure 4).

CONCLUSIONS
We report the occurrence and 317 cases of microcephaly in the State of Ceará, Northeast Brazil.In addition to impairment of the cephalic perimeter, other associated malformations, such 12 orthopedic deformity. 13The microcephaly phenotype caused by zika virus is different from other congenital conditions.The 14 Thus, a great challenge for the public health of Brazil and in the the disease, through timely diagnosis, appropriate treatment sequelae, psychological support for families and production of vaccines.
outbreak in the state of Ceará in Northeast outbreak in Ceará its clinical characteristics in each medical speciality.

Graphic 1 .
Ceará, Brazil, 2015 and 2016.congenital anomalies of the Central Nervous System (CNS), such as iniencephaly structural defects, such as multiple arthrogryposis congenita.signs of posterior fossa abnormalities (cerebellar hypoplasia, hypoplasia of the cerebellar vermis, enlargement of the the corpus callosum).maternal and infants.presented negative results for toxoplasmosis, rubella, Brain imaging this investigation as part of routine clinical practice; but the From mid-2015 to the end of June of 2016, a total of 417 cases of Graphic 1). st

Figure 2 .
Figure 2. Microcephaly in children born alive in the State of Ceará, Brazil.