CEREBRAL INFARCTION IN PATIENTS WITH AIDS

PURPOSE: To establish the frequency, distribution, and pathogenesis of cerebral infarction as confirmed with MR imaging in a cohort of patie nts with acquired immunodeficiency syndrome (AIDS). METHODS: We review ed all (71) abnormal cranial MR studies obtained at our institution in human immunodeficiency virus (HIV)-positive patients over a 2-year pe riod and recorded the number and distribution of ischemic lesions, any associated abnormalities, and the MR angiographic findings, where ava ilable. patients' charts were studied for relevant clinical data, bioc hemical and culture results, and potential etiologic factors. RESULTS: Twenty-two infarcts were seen in 13 of the 71 patients. Of these 22, the basal ganglia area was affected in 15, the middle cerebral artery territory in two, and the vertebrobasilar territory in five. Five pati ents had concomitant evidence of infection, six others used cocaine or were intravenous drug abusers. MR angiography was performed in eight patients; two of these had multiple lesions consistent with vasculitis , two had isolated lesions that corresponded with their parenchymal in farct, and four had normal findings. CONCLUSIONS: The frequency of inf arction was 18%, higher than previously reported. The pathogenesis of infarction was multifactorial. Underlying infectious causes were ident ified in 39% of patients. Two patients had an idiopathic vasculitis.