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Cerebral infarction in patients with AIDS

A R Gillams1, E Allen, K Hrieb

  • 1Department of Radiology, Boston University Medical School, MA, USA.

AJNR. American Journal of Neuroradiology
|September 20, 1997
PubMed
Summary

Cerebral infarction occurred in 18% of patients with acquired immunodeficiency syndrome (AIDS), a higher rate than previously known. Multifactorial causes, including infections and substance abuse, contributed to this increased risk.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Acquired immunodeficiency syndrome (AIDS) is associated with various neurological complications.
  • Cerebral infarction (stroke) is a recognized but not fully understood complication in human immunodeficiency virus (HIV)-positive individuals.

Purpose of the Study:

  • To determine the incidence, location, and causes of cerebral infarction in patients with AIDS using Magnetic Resonance (MR) imaging.
  • To investigate the pathogenesis of stroke in this vulnerable population.

Main Methods:

  • Retrospective review of 71 abnormal cranial MR studies in HIV-positive patients over two years.
  • Analysis of lesion distribution, associated abnormalities, and MR angiography findings.
  • Correlation with clinical data, laboratory results, and potential etiologic factors from patient charts.

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Main Results:

  • Cerebral infarction was detected in 13 of 71 patients (18%), with 22 infarcts identified.
  • The basal ganglia were the most commonly affected area (15 infarcts).
  • Infectious causes were implicated in five patients; substance abuse (cocaine/IVDU) was noted in six. MR angiography revealed vasculitis in two patients.

Conclusions:

  • The observed 18% frequency of cerebral infarction in AIDS patients is higher than previously reported.
  • Stroke pathogenesis in this cohort is multifactorial, with infections playing a significant role in 39% of cases.
  • Idiopathic vasculitis was identified as a cause in two patients.