Unusual pattern of magnetic resonance imaging findings in congenital cytomegalovirus infection presenting with congenital sensorineural hearing loss: A case report

Congenital cytomegalovirus (cCMV) infection is the leading non-genetic cause of sensorineural hearing loss (SNHL) in children. This report highlights an atypical magnetic resonance imaging (MRI) presentation: Bilateral anterior temporal pole cysts and diffuse white matter abnormalities in an infant with isolated bilateral SNHL. We present a case of a male infant with bilateral congenital SNHL. MRI showed bilateral anterior temporal cysts and diffuse periventricular white matter hyperintensities with no suspicious antenatal history or more common features such as microcephaly, calcifications, or cortical anomalies. Confirmatory testing revealed cCMV infection. This case underscores the diagnostic value of MRI in detecting subtle manifestations of cCMV. Recognition of anterior temporal pole cysts, even in the absence of classic features, can guide timely diagnosis and treatment, potentially improving auditory and neurodevelopmental outcomes.