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Recurrent Stroke as a Manifestation of Primary Angiitis of the Central Nervous System in a Patient Infected With Human Immunodeficiency Virus
Carmen Nogueras, MD;
Montserrat Sala, MD;
Mercè Sasal, MD;
Jaume Viñas, MD;
Natalia Garcia, MD;
Maria-Rosa Bella, MD;
Manuel Cervantes, MD;
Ferran Segura, MD
Arch Neurol. 2002;59:468-473.
Context Cerebral vasculitis in patients infected with human immunodeficiency
virus (HIV) is usually related to additional or secondary infectious agents
other than neoplastic diseases or HIV itself.
Objective To describe a 31-year-old patient infected with HIV who presented with
2 recurrent, acute episodes of neurologic impairment in a 5-month period.
Design Comparison of clinical and histologic data between the present case
and previously published cases.
Setting Community hospital.
Patient A 31-year-old, HIV-infected patient with recurrent strokes and chronic
lymphocytic meningitis.
Intervention After ruling out cardiac embolisms and coagulation disorders, the presence
of central nervous system vasculitis, probably secondary to an infectious
process, was suspected based on the clinical examination and cerebrospinal
fluid abnormalities.
Results Necropsy findings suggest the diagnosis of primary angiitis of the central
nervous system, and the only infectious agent that could be found was HIV.
Conclusions Histologic studies were compatible with a diagnosis of primary angiitis
of the central nervous system, but the pathogenic role of HIV in the genesis
of the vasculitic process cannot be elucidated.
From the Department of Internal Medicine, Infectious Diseases Program
(Drs Nogueras, Sala, Sasal, Garcia, Cervantes, and Segura), and Departments
of Neurology (Dr Viñas) and Pathology (Dr Bella), Corporació
Sanitària Parc Taulí, Sabadell, Barcelona, Spain.
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