Extracranial ectasia and embolic infarcts in HIV: two case reports and a clinical decision-making algorithm
| Autor: | John W. Cole, Rakhee Lalla, Prashant Raghavan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Neurology Substance-Related Disorders Clinical Decision-Making Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Article 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine Fibrinolytic Agents Clinical decision making Virology Ectasia Coagulopathy Humans Medicine Intraluminal thrombus Stroke Thrombectomy business.industry HIV Thrombosis Cerebral Infarction Middle Aged medicine.disease 030104 developmental biology Tissue Plasminogen Activator Etiology Female Neurology (clinical) business Algorithm Algorithms 030217 neurology & neurosurgery Dilatation Pathologic |
| Zdroj: | J Neurovirol |
| ISSN: | 1538-2443 1355-0284 |
| DOI: | 10.1007/s13365-020-00867-8 |
| Popis: | HIV is known to increase the risk of both ischemic and hemorrhagic strokes. There are many postulated mechanisms for this elevated risk including an HIV-induced vasculopathy and/or coagulopathy, opportunistic infections, and cardioembolic etiologies, among others. Regarding vasculopathy, prior reports have described the various changes to the arterial vasculature that can occur in the setting of HIV, yet the appropriate workup and management of this condition remains poorly defined. Here we describe two cases of patients with HIV presenting with large vessel intracranial occlusions in the setting of ectatic extracranial vasculature accompanied by intraluminal thrombus formation. One patient underwent thrombectomy, while the other improved after receiving IV-tPA. Inferring on these cases and the existing literature, a standardized workup and treatment algorithm is proposed, emphasizing the key management decisions that should be considered on a case-by-case basis. |
| Databáze: | OpenAIRE |
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