Document 0451
 DOCN  M9620451
 TI    [Clinical and paraclinical diagnosis of AIDS neurologic lesions]
 DT    9602
 AU    Bossi P; Astagneau P; Bricaire F; Service de maladies infectieuses,
       parasitaires et tropicales,; Groupe hospitalier Pitie-Salpetriere,
       Paris.
 SO    J Neuroradiol. 1995 Sep;22(3):142-7. Unique Identifier : AIDSLINE
       MED/96043307
 AB    Seventy to eighty percent of HIV-infected patients exhibit neurological
       disorders at an advanced stage of the disease. In almost 90% of cases
       anatomical examination of brains shows histological lesions. Even when
       often reversible neurological disorders occur during the HIV primary
       infection, most of the manifestations of central nervous system (CNS)
       damage remains the prerogative of severe immunodepression. The principal
       CNS lesions associated with HIV infection are presented here with the
       clinical and biological elements that lead to the diagnosis. Cerebral
       toxoplasmosis holds a privileged place in these manifestations since it
       responds to an efficient curative and prophylactic treatment with a
       well-codified medical care based on the test treatment. Biological data,
       therefore, only have a contributing value. HIV encephalopathy is
       frequent, but the dementia syndrome is less frequent than the finding of
       associated imaging and pathological anatomy: atrophy and lesions of the
       white matter. Thus, the dementia complex is an elimination diagnosis.
       Cryptococcosis must be systematically considered, not only in patients
       with meningeal symptoms and headaches, but also with those with isolated
       fever. The demonstration of cryptococcus and cryptococcic antigen in the
       CSF has an almost absolute diagnostic value; imaging plays a very small
       diagnostic role, looking for an exceptional cryptococcoma. Multifocal
       progressive leukoencephalopathy benefits from the accuracy of MRI, and
       the diagnosis is usually based on clinical data, MRI and evidence of the
       virus in the CSF by PCR, even though the only mean of obtaining full
       proof is, in theory, stereotaxic biopsy. Primary cerebral lymphoma is
       the diagnostic alternative to toxoplasmosis.(ABSTRACT TRUNCATED AT 250
       WORDS)
 DE    AIDS Dementia Complex/*DIAGNOSIS/PATHOLOGY  AIDS-Related Opportunistic
       Infections/DIAGNOSIS  Brain Diseases/DIAGNOSIS/MICROBIOLOGY/VIROLOGY
       Brain Neoplasms/DIAGNOSIS  Cryptococcosis/DIAGNOSIS  Cytomegalovirus
       Infections/DIAGNOSIS  Diagnosis, Differential  English Abstract  Human
       Leukoencephalopathy, Progressive Multifocal/DIAGNOSIS  Lymphoma,
       AIDS-Related/DIAGNOSIS  Toxoplasmosis, Cerebral/DIAGNOSIS  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

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