HIV-associated multiple intracranial aneurysms and stroke in an adult patient: successful treatment with a combination of glucocorticoid and antiviral agents.

Autor: Sabi MS; Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran., Mousavian P; Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran. medmoosavian@yahoo.com., Sasannejad P; Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran., Hezarkhani LA; Neuroscience Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran., Salimnia N; Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran., Oryani MA; Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Malekzadeh M; Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran., Moosavian H; Department of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
Jazyk: angličtina
Zdroj: Journal of neurovirology [J Neurovirol] 2023 Feb; Vol. 29 (1), pp. 106-110. Date of Electronic Publication: 2022 Dec 13.
DOI: 10.1007/s13365-022-01106-y
Abstrakt: A 35-year-old Iranian man with an 18-year history of human immunodeficiency virus (HIV) infection developed sudden left-sided hemiparesis and mild dysarthria. Based on laboratory results, brain and neck computerized tomography angiography (CTA), echocardiography, hypercoagulability tests, and vasculitis tests, the patient was diagnosed with a stroke with multiple intracranial aneurysms secondary to HIV. Cerebral aneurysms and stroke are uncommon in HIV-infected patients, and the aneurysms' exact cause and risk factors are unknown. There is currently no effective regimen or definitive treatment for HIV-associated vasculitis. In the present study, the patient recovered without any neurological deficits following treatment with oral prednisolone, combined with combination antiretroviral therapy (cART), valacyclovir, and antiplatelet medication. Furthermore, after 2 months of immunosuppressive treatment, all imaging abnormalities improved, and no new events were observed at the 20-month follow-up. To the best of our knowledge, this is the first case in which a patient with HIV-associated vasculopathy and stroke has survived successfully, and all angiographic abnormalities completely eliminated.
(© 2022. Journal of NeuroVirology, Inc.)
Databáze: MEDLINE
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