Brain imaging in AIDS

Although central nervous system (CNS) involvement is common in the population with acquired immunodeficiency syndrome, the presenting neurologic signs and symptoms are often vague and nonfocal. This represents a significant diagnostic challenge for the primary care physician. Cross-sectional imaging now plays an important role in the diagnosis of pathologic processes involving the brain in HIV-infected patients. Involvement of the brain with atypical viruses, parasites, fungi, and neoplasms is more prevalent in AIDS patients. On identification of a brain lesion, it is the role of the imager to characterize it in an attempt to provide a limited differential diagnosis. We review the imaging findings of the pathogens that most commonly affect the brain in AIDS patients.