STROKE AND CEREBRAL INFARCTS IN CHILDREN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Objective: To study the causes of stroke and cerebral infarcts in chil dren infected with the human immunodeficiency virus (HIV)-type 1. Desi gn: Case series. Patients: Four of 380 HIV-infected children followed up ina 10-year period in our department who had a stroke with evidence of cerebral infarcts on radiological imaging. Results: The four patie nts were severely immunodepressed, but their clinical status and outco me were different. Aneurysmal dilation of major cerebral arteries and thrombosis of these arteries or of small cortical vessels were discove red in two patients. Both patients had a history of frequent infection s and had suffered repeated neurological events that resulted in sever e clinical deterioration or death. An infectious causative agent was s trongly suspected but was not detected. The other two patients had a m ore favorable outcome. An isolated cerebrovascular thrombosis was foun d in one patient, while in the other, HIV-1-related focal necrosis was suggested by the lack of permanent cerebrovascular abnormalities or t hrombosis and by signs of necrosis in biopsy specimens of the brain. C onclusion: Stroke and cerebral infarcts in HIV-1 infected children hav e different causes and different prognoses.