RT Journal Article
SR Electronic
T1 AIDS-related MR hyperintensity of the basal ganglia.
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 83
OP 89
VO 19
IS 1
A1 C C Meltzer
A1 S W Wells
A1 M W Becher
A1 K M Flanigan
A1 G A Oyler
A1 R R Lee
YR 1998
UL http://www.ajnr.org/content/19/1/83.abstract
AB PURPOSE Our goal was to describe the MR imaging appearance and clinical pathologic correlates of bilateral basal ganglia hyperintensity in acquired immunodeficiency syndrome (AIDS).METHODS Medical records and laboratory data were reviewed retrospectively in nine cases of bilateral basal ganglia hyperintensity on long-repetition-time MR images. Opportunistic infections of the central nervous system were excluded by clinical and laboratory data. Postmortem neuropathologic examination was obtained in two cases.RESULTS All patients presented acutely with new seizures or changes in mental status. A history of drug abuse was elicited in seven of the nine remaining patients. Renal failure was present in six cases. Symmetric bilateral caudate and putamen hyperintensity on T2-weighted images was found in all cases with variable extension to the surrounding white matter, thalamus, and brain stem. Postmortem neuropathologic examination in two cases revealed numerous microinfarcts in a distribution similar to the MR signal abnormalities.CONCLUSION The MR appearance of basal ganglia hyperintensity in this series of AIDS patients represents ischemic tissue injury. We propose that this clinicopathologic entity is precipitated by the combined effects of human immunodeficiency virus infection and drug use, particularly cocaine and/or associated toxic contaminants.