Magnetic resonance imaging findings in HIV cognitive impairment
K. D. Kieburtz, L. Ketonen, A. E. Zettelmaier, D. Kido, E. D. Caine and J. H. Simon
Department of Neurology, University of Rochester Medical Center, NY 14642.
Atrophy and white matter changes seen on magnetic resonance imaging scans
have been observed in association with the acquired immunodeficiency
syndrome dementia complex, but these appear to be late findings relative to
clinical expression. We report a new magnetic resonance imaging observation
in patients with early cognitive impairment due to human immunodeficiency
virus infection. Fifty-two patients had a total of 86 magnetic resonance
imaging scans during the study period. All scans were obtained with a 1.5-T
system. The proton density spin echo (repetition time of 2000 milliseconds
and echo delay time of 30 milliseconds) study demonstrated high-signal
lesions in the region of the splenium of the corpus callosum and in the
crura of the fornices. The lesions demonstrated no contrast enhancement
with gadopentate dimeglumine. Pathological examination was performed in
five patients. The fornix-subcallosal abnormality may be related to the
memory dysfunction in patients with human immunodeficiency virus-related
cognitive impairment.
