Abstract
Microcephaly is defined as an occipitofrontal head circumference two standard deviations (2SD) below average for age and sex, with severe microcephaly below three standard deviations (3SD). Congenital toxoplasmosis is one of the congenital infections that can potentially lead to microcephaly. It reflects neurotropism for fetal central nervous system (CNS) cells from toxoplasma, causing massive destruction of neural tissue, resulting in serious neurological damage. We present a case of severe microcephaly observed at birth in a newborn from an unmonitored pregnancy with an unknown maternal serological profile. The mother, aged 25 years, had no prior medical history. Imaging investigations revealed significant neurological lesions, while serological tests confirmed congenital toxoplasmosis. This case report illustrates the radiological semiology of neurological involvement in congenital toxoplasmosis and serves as a reference for radiologists, highlighting the importance of recognizing the radiological features of congenital toxoplasmosis.