Thursday, May 21, 2009
HIV encephalitis
Findings
Mild parenchymal volume loss with symmetric nonenhancing periventricular and subcortical white matter T2 prolongation. No mass effect.
Differential diagnosis:
- Microvascular disease
- HIV encephalitis
- PML
- Toxo/lymphoma
- Chemotherapy/Radiation
- Leukodystrophy
- Demyelination – MS, ADEM
Diagnosis: HIV encephalitis (known HIV infection).
Key Points: HIV Encephalitis / AIDS Dementia complex
Cognitive disturbances that progress to dementia
7-27% of AIDS patients
Direct CNS infection by HIV +/- CMV
MR imaging primarily shows central volume loss and diffuse or periventricular white matter disease (both demyelination and gliosis)
Can be difficult to differentiate from PML
Pre-HAART (Highly Active Antiretroviral Therapy) prognosis was poor, but HAART therapy is felt to decrease incidence and induce remission.
Labels:
AuntMinnie,
Infectious,
Neuro
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