Cerebral infarction in adult AIDS patients: observations from the Edinburgh HIV Autopsy Cohort - PubMed (original) (raw)
Cerebral infarction in adult AIDS patients: observations from the Edinburgh HIV Autopsy Cohort
M D Connor et al. Stroke. 2000 Sep.
Abstract
Background and purpose: Autopsy series of patients with AIDS have found a 4% to 29% prevalence of cerebral infarction. Little is known of the prevalence of cerebral infarction when not associated with non-HIV central nervous system (CNS) infection, lymphoma, or cardioembolic sources. Clinical correlation has seldom been available. We describe the pathological and clinical features of patients from the Edinburgh HIV Cohort Study found to have had cerebral infarcts without evidence of non-HIV CNS infection, CNS lymphoma, or cardioembolic sources at autopsy.
Methods: From 183 autopsy cases, 26 without evidence of opportunistic cerebral infection or lymphoma were selected. These 26 cases went through a second selection process in which the presence of cerebral infarction, in the absence of the conditions mentioned, was verified. Histology and clinical records for the remaining patients were reviewed.
Results: Ten (5.5%) cases fulfilled the inclusion criteria and demonstrated similar hypoxic-ischemic lesions. Small-vessel thickening was seen in all cases, and perivascular space dilatation, rarefaction, and pigment deposition, with vessel wall mineralization and perivascular inflammatory cell infiltrates, were seen in some cases. Vasculitis was not found. One patient had had a transient ischemic attack, and no patient had had a stroke.
Conclusions: Cerebral infarcts in HIV-infected patients are not common in the absence of cerebral non-HIV infection, lymphoma, or embolic sources. We found an HIV-associated vasculopathy with similar features in all risk groups. In AIDS patients presenting with stroke or transient ischemic attack, potentially treatable causes, such as cerebral coinfection or tumor, should be sought.
Similar articles
- Influence of risk group and zidovudine therapy on the development of HIV encephalitis and cognitive impairment in AIDS patients.
Bell JE, Donaldson YK, Lowrie S, McKenzie CA, Elton RA, Chiswick A, Brettle RP, Ironside JW, Simmonds P. Bell JE, et al. AIDS. 1996 May;10(5):493-9. doi: 10.1097/00002030-199605000-00007. AIDS. 1996. PMID: 8724040 - Cerebral infarctions and transient neurologic deficits associated with acquired immunodeficiency syndrome.
Engstrom JW, Lowenstein DH, Bredesen DE. Engstrom JW, et al. Am J Med. 1989 May;86(5):528-32. doi: 10.1016/0002-9343(89)90379-3. Am J Med. 1989. PMID: 2712060 - AIDS and cerebrovascular disease.
Pinto AN. Pinto AN. Stroke. 1996 Mar;27(3):538-43. doi: 10.1161/01.str.27.3.538. Stroke. 1996. PMID: 8610326 Review. - HIV encephalitis, proviral load and dementia in drug users and homosexuals with AIDS. Effect of neocortical involvement.
Bell JE, Brettle RP, Chiswick A, Simmonds P. Bell JE, et al. Brain. 1998 Nov;121 ( Pt 11):2043-52. doi: 10.1093/brain/121.11.2043. Brain. 1998. PMID: 9827765
Cited by
- Macroscopic and Microscopic Cerebral Findings in Drug and Alcohol Abusers: The Point of View of the Forensic Pathologist.
Montana A, Alfieri L, Neri M, Piano D, Renier E, Marti M, Palpacelli M, Basile G, Tossetta G, Busardò FP. Montana A, et al. Biomedicines. 2024 Mar 19;12(3):681. doi: 10.3390/biomedicines12030681. Biomedicines. 2024. PMID: 38540294 Free PMC article. Review. - Multiple fusiform and saccular aneurysms in a person living with Human Immunodeficiency Virus.
Unice T, Naidoo P, Hiralal P, Naidoo Y, Pillay S. Unice T, et al. SAGE Open Med Case Rep. 2023 Nov 16;11:2050313X231211048. doi: 10.1177/2050313X231211048. eCollection 2023. SAGE Open Med Case Rep. 2023. PMID: 38022860 Free PMC article. - Stroke in central nervous system infections.
Carod-Artal FJ. Carod-Artal FJ. Ann Indian Acad Neurol. 2008 Jan;11(Suppl 1):S64-S78. Ann Indian Acad Neurol. 2008. PMID: 35721447 Free PMC article. Review. - High-resolution intracranial vessel wall imaging in cerebral viral infections evaluations.
Vyas S, Choudhary N, Modi M, Sankhyan N, Suthar R, Saini AG, Bansal A, Sharma N, Singh P. Vyas S, et al. Neuroradiology. 2022 May;64(5):915-924. doi: 10.1007/s00234-021-02831-7. Epub 2021 Oct 16. Neuroradiology. 2022. PMID: 34657167 Free PMC article. - Role of Brain Arterial Remodeling in HIV-Associated Cerebrovascular Outcomes.
Spagnolo-Allende A, Gutierrez J. Spagnolo-Allende A, et al. Front Neurol. 2021 Jun 22;12:593605. doi: 10.3389/fneur.2021.593605. eCollection 2021. Front Neurol. 2021. PMID: 34239489 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical