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1996-02-26
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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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).