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Cerebrovascular Disease in HIV-Infected Pediatric Patients: Neuroimaging Findings

Athos D. Patsalides1, Lauren V. Wood2, Gokce K. Atac1, Eileen Sandifer2, John A. Butman1 and Nicholas J. Patronas1

1 Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Rm. 1C-660, Bethesda, MD 20892-1182.
2 HIV & AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1868.



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  		Fig. 1A. —10-year-old HIV-infected boy with left-sided hemiparesis. Multiple ischemic infarctions are located in vascular territories harboring fusiform aneurysms. MR angiogram of proximal intracranial circulation shows aneurysmal dilatation of proximal segment of right anterior and right middle cerebral arteries (long arrows). There is also less prominent dilatation of left posterior cerebral artery (short arrow) and basilar artery.

 


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  		Fig. 1B. —10-year-old HIV-infected boy with left-sided hemiparesis. Multiple ischemic infarctions are located in vascular territories harboring fusiform aneurysms. Axial T2-weighted MR image shows two lacunar infarctions in left thalamus and right putamen (arrows). Two other ischemic infarctions are identified in right occipital and right frontal lobes.

 


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  		Fig. 1C. —10-year-old HIV-infected boy with left-sided hemiparesis. Multiple ischemic infarctions are located in vascular territories harboring fusiform aneurysms. Fluid-attenuated inversion recovery MR image obtained in axial plane shows ischemic infarction involving medial aspect of right frontal lobe (arrow).

 


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  		Fig. 2A. —12-year-old HIV infected girl without focal neurologic symptoms. MR angiogram of proximal intracranial circulation shows abnormal dilatation of left anterior cerebral artery (arrow).

 


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  		Fig. 2B. —12-year-old HIV infected girl without focal neurologic symptoms. Fluid-attenuated inversion recovery MR image of brain obtained in axial plane shows two ischemic infarctions in left putamen and caudate nucleus (arrows). Both infarcted areas are supplied by lenticulostriate arteries originating from abnormally dilated anterior cerebral artery.

 

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