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Cerebrovascular complications of HIV in children
S S Shah1, R A Zimmerman, L B Rorke
1Department of Radiology, Children's Hospital of Philadelphia, PA 19104, USA.
Insights
Human immunodeficiency virus (HIV) infection in children can cause rare cerebrovascular issues like arteritis and arterial sclerosis. Imaging and autopsy confirmed ischemic lesions and arteriopathy in affected children.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Infectious Diseases
Background:
- Human immunodeficiency virus (HIV) infection can lead to cerebrovascular complications in children.
- Uncommon manifestations include arteritis with fusiform aneurysms and arterial sclerosis with vascular occlusion.
Observation:
- A study examined CT and MR imaging in three children (9-18 years) with HIV.
- Findings were compared with autopsy results in two patients.
- One child showed subacute infarction; two had fusiform dilatation of the Circle of Willis vessels.
Findings:
- Imaging and autopsy confirmed ischemic lesions and arteriopathy in the studied children.
- Fusiform aneurysms and arterial sclerosis were key cerebrovascular findings associated with pediatric HIV.
- One case incidentally revealed a B-cell lymphoma not detected by imaging.
Implications:
- Highlights the importance of neuroimaging in diagnosing cerebrovascular complications in pediatric HIV.
- Suggests potential for early detection and management of vascular issues in HIV-infected children.
- Underscores the diverse neurological manifestations of HIV in pediatric populations.
Abstract:
Two uncommon but important cerebrovascular manifestations of human immunodeficiency virus (HIV) infection in children are arteritis with formation of fusiform aneurysms and arterial sclerosis with vascular occlusion. We studied the CT and MR imaging features of HIV in two girls and one boy (9 to 18 years old) and compared them with autopsy findings in two patients. One of the children had findings consistent with small areas of subacute infarction and the other two had fusiform dilatation of the major vessels of the circle of Willis. The ischemic lesions and arteriopathy were confirmed at autopsy. In one patient, an incidental B-cell lymphoma (not visible on the imaging studies) was diagnosed.