Neurologic Abnormalities in Human Immunodeficiency Virus Infection

, Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, La 

South Med J. 2001;94(3) 

In This Article

Evaluation of Brain Lesions

Infections that primarily cause meningitis (eg, tuberculosis and cryptococcosis) may also cause focal parenchymal brain lesions, usually extending from the cisternal and sulcal CSF spaces. Using an algorithm (Figure), supplemented by serologic studies and PCR, the diagnosis is usually established[58]; however, brain biopsy may be needed. Due to the occurrence of coagulation disorders and poor immune response of HIV-positive patients, neurosurgical intervention is poorly tolerated and should be avoided if possible.

Figure 1. Algorithm for management of focal brain lesions in patients with human immunodeficiency virus. (CT = Computed tomography; MRI = magnetic resonance imaging; PCR = polymerase chain reaction; CSF = cerebrospinal fluid; PML = progressive multifocal leukoencephalopathy; LP = lumbar puncture.)

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