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Stroke Caused by Human Immunodeficiency Virus–Associated Vasculopathy?—Reply
Brent Tipping, MBChB, FCP, MPhil;
Linda de Villiers, MBChB;
Sally Candy, MBChB;
Helen Wainwright, MBChB
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In reply
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] AUTHOR INFORMATION
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