Reduced cerebral blood flow in early stages of human immunodeficiency virus infection
E. Schielke, K. Tatsch, H. W. Pfister, C. Trenkwalder, G. Leinsinger, C. M. Kirsch, A. Matuschke and K. M. Einhaupl
Department of Neurology, Klinikum Grosshadern, University of Munich Federal Republic of Germany.
In order to determine if brain perfusion abnormalities, which are known in
patients with acquiredimmunodeficiency syndrome dementia, occur in early
stages of human immunodeficiency virus infection, technetium 99m
hexamethyl-propyleneamine oxime-single-photon emission computed tomography
studies were performed in 20 patients infected with human immunodeficiency
virus who belonged to Walter Reed stages I through IV. None of these
patients demonstrated signs of dementia or severe neurological dysfunction.
Pathological patterns of hexamethyl-propyleneamine oxime uptake were seen
in 14 patients, seven of whom had normal results during neurological
examination. Only four patients had signs of cerebral atrophy on cranial
computed tomographic scan. These data suggest that subtle changes in
cerebral perfusion seem to arise early in the course of human
immunodeficiency virus infection and may indicate human immunodeficiency
virus encephalopathy before neurological symptoms or noticeable structural
damage occurs.
