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Pim Brouwers, PhD; Charles DeCarli, MD; Lucy Civitello, MD; Howard Moss, PhD; Pam Wolters, PhD; Philip Pizzo, MD

Arch Neurol. 1995;52(1):39-44.

Abstract
Objective
To evaluate the clinical significance of computed tomographic brain scan abnormalities observed in children with symptomatic human immunodeficiency virus disease.

Patients
Eighty-seven previously untreated children with symptomatic human immunodeficiency virus type 1 disease.

Methods
General levels of cognitive functioning, obtained from age-appropriate intelligence tests, and socialemotional behavior were correlated with computed tomographic brain scan abnormality ratings.

Results
A significant relation between computed tomographic brain scan abnormalities and cognitive dysfunction as well as aberrant behavior was found, which appeared stronger in (younger) vertically infected children compared with transfusion-infected patients. Calcifications, independent from the degree of brain atrophy, were associated with significantly greater delays in neurocognitive development.

Conclusion
Computed tomographic brain scan abnormalities, even when mild, were of clinical significance, suggesting that human immunodeficiency virus—associated central nervous system compromise is a continuous process and that scans may be helpful at baseline in defining patients at risk and for monitoring them during therapy.

Author Affiliations
From the Pediatric Branch, National Cancer Institute (Drs Brouwers, Civitello, Moss, Wolters, and Pizzo), and the Epilepsy Research Branch, National Institute of Neurological Disorders and Stroke (Dr DeCarli), Bethesda, Md; Children's National Medical Center, Washington, DC (Dr Civitello); and Medical Illness Counseling Center, Chevy Chase, Md (Drs Moss and Wolters).

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