HIV - What can we learn from a MRI or CT scan?
Various abnormalities are of course possible, but these can be roughly divided schematically into:
- Ring-enhanced single lesion: abscess, with frequency toxoplasmosis > TB > cryptococcosis. The peripheral staining by the contrast medium shows the oedema zone around the abscess. On this basis a test therapy will often be started without having formal proof of toxoplasmosis. If there is no improvement within two weeks or if deterioration occurs, a stereotactic brain biopsy should be performed. In addition to these three etiologies, there can be other causes of an intracranial mass: herpes, Histoplasma, Nocardia, Candida, Kaposi, metastasis. In 10% of cases no specific cause is found.
- Non-ring enhanced lesion: probably lymphoma > PML. In case of PML there is no mass effect.
- Bilateral diffuse lesions: immune reconstitution syndrome if in the correct context.
- Multiple ring lesions: toxoplasmosis >> tuberculosis.
- HIV atrophy: broadened sulci and enlarged ventricles (DD internal hydrocephalus: flattened sulci and enlarged ventricles).
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Posted in
Brain
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Conditions and Diseases
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Health
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HIV
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Immune reconstitution inflammatory syndrome
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Infectious disease
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Medical Subject Notes
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Progressive multifocal leukoencephalopathy
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Tuberculosis
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29.12.09|By
Vishaal
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