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[Cerebral infarction in human immunodeficiency virus infection]
P Blanche1, P Toulon, A de La Blanchardière
1Service de Médecine interne, Hôpital Cochin, Université René Descartes, Paris.
Presse Medicale (Paris, France : 1983)
|June 3, 1995
Summary
Patients with acquired immune deficiency syndrome (AIDS) face a high risk of ischemic stroke. While coagulation disorders were noted, other factors like immune complexes and HIV toxicity are likely key causes.
Area of Science:
- Neurology
- Infectious Diseases
- Hematology
Background:
- Patients with human immunodeficiency virus (HIV) infection exhibit an increased risk of ischemic cerebral events.
- Acquired immune deficiency syndrome (AIDS) is associated with neurological complications, including cerebrovascular disease.
Observation:
- Two cases of cerebral infarction in homosexual men with AIDS, aged 38 and 37, are presented.
- Clinical presentations included hemiparesia and epilepsy; imaging revealed cerebral infarcts and carotid artery occlusion.
- Coagulation studies showed free protein S and heparin cofactor II deficiencies, but no endocarditis, dissection, or disseminated intravascular coagulation.
Findings:
- Cerebral infarction occurred in two AIDS patients with specific coagulation abnormalities (protein S and heparin cofactor II deficiency).
- Standard causes of stroke such as endocarditis, arterial dissection, and vasculitis were ruled out.
- Anticoagulant therapy led to a favorable outcome in both cases.
Implications:
- Coagulation anomalies alone may not fully explain ischemic stroke in AIDS patients.
- Direct HIV toxicity on endothelial cells, immune complex deposition, and cytokine effects are potential contributing mechanisms.
- Further research is needed to elucidate the complex pathophysiology of cerebrovascular events in HIV/AIDS.