Thursday 26 January 2012

HIV Encephalitis – Encephalopathy

Syn: HIV- 1 Encephalitis / Encephalopathy, HIVE.
A syndrome of cognitive, behavioural and motor abnormalities attributed to direct effect of HIV on brain, in absence of opportunistic infection.
Most freqauent neurological manifestation of HIV infection.
Atrophy with bilateral symmetric confluent peri ventricular white matter disease, hypodense on CT and T2 hyperintense on MRI is a diagnostic clue.
Clinical finding should guide imaging finding and not reverse.
Affect any age group and gender.

A 60 yo  male, known Reactive for HIV came for follow up imaging. 
MRI T2w images show bilateral symmetrical confluent peri ventricular T2 white matter hyperintensity. Mild diffuse cerebral cortical atrophy. 

DD is PML (Progressive Multifocal Leukoencephalopathy) , seen in same clinical  setting, characterised by patchy non enhancing white matter lesions, may be unilateral but more often bilateral and asymmetrical. Common in fronto parietal regions.

A case of  

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