Intracranial lesions in the acquired immunodeficiency syndrome: radiological (computed tomographic) features

AS A result of a marked decrease in cell-mediated immunity, patients with the acquired immunodeficiency syndrome (AIDS) are devastated by multiple opportunistic infections and neoplasms. While the etiology remains unproven, the mortality approaches 100%. 1 Most patients present with Pneumocystis carinii pneumonia and/or Kaposi's sarcoma. Neurological signs and symptoms occur in 30% to 75% of cases, varying from weakness and paresthesias to progressive dementia, seizures, focal deficits, and hallucinations. 2,3 Pathogens that have been implicated in the involvement of the central nervous system (CNS) include Toxoplasma gondii , 4 Cryptococcus neoformans , 4 papovavirus, 5 Candida albicans , 2 cytomegalovirus, 1 Mycobacterium tuberculosis , 6 Aspergillis fumigatus , 3 and possibly Mycobacterium avium-intracellulare . 2 Primary CNS lymphoma, 7 secondary involvement of the CNS by systemic lymphoma, 2 plasmacytoma, 2 and Kaposi's sarcoma 8 constitute the usual neoplasms observed in AIDS. Thrombocytopenia in patients with AIDS predisposes them to cerebral hemorrhage, while nonbacterial thrombotic endocarditis results