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Brent Tipping, MBChB, FCP, MPhil; Linda de Villiers, MBChB; Sally Candy, MBChB; Helen Wainwright, MBChB

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Vasculopathy similar to that seen in our patient has been reported in an HIV-infected neonate with herpes simplex encephalitis.¹ Likewise, cytomegalovirus involvement of cerebral vessels leading to infarction has been described.² This report by Kieburtz and colleagues² also described HIV-associated primary central nervous system lymphoma invading cerebral blood vessel walls with resultant infarction. Primary central nervous system lymphomas in HIV are associated with Epstein-Barr virus in up to 100% of cases.³

Large vessel intracranial aneurysmal vasculopathy as seen in our patient is increasingly reported in adult HIV-positive patients.^4-6 In our report, we postulated a plausible mechanism of aneurysm formation. This mechanism included the role of opportunistic infections.⁶ Accumulated observations to date support the association of HIV infection with this peculiar intracranial vasculopathy, which is not recognized in HIV-negative individuals.

Three reported adult cases . . . [Full Text of this Article]

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