Skip to main content
SpringerLink
Log in

CT Findings in the Brain of Adult Patients with HIV/AIDS

  • Chapter
Brain Degeneration and Dementia in Sub-Saharan Africa

Abstract

The availability of modern imaging techniques of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans have enabled us to investigate and study brain conditions of HIV CNS involvement commonly seen in Sub-Saharan Africa. Computed Tomography scan of the head displays a two dimensional anatomy of the brain in the form of cross-sectional images enabling one to see structures enclosed within the skull bones. The structural changes due to intracranial pathologies can be easily detected and administration of intravenous iodinated contrast medium further characterizes these lesions to aid in diagnosis. The earlier radiological methods of investigating intracranial pathology, like pneumo-encephalography, conventional angiography or even skull x-rays were invasive or provided limited information. Ultrasound is only applicable in young children before closure of the fontanelle or if adults in the presence of a bone defect, like a burr hole.

This chapter will review degenerative brain changes in HIV/AIDS patients due to HIV-related infections, viremia, malignancy, neuronal death, demyelination or those involving the meninges, ventricles, arachnoid matter and also lesions due to bleeds from a variety of causes. However, normal Contrasted CTs were also a common finding despite documented HIV CNS involvement. This calls for more stringent guidelines for ordering this, expensive but otherwise new and modern useful neuro-imaging investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

HIV:

Human immunodeficiency virus

CSF:

Cerebrospinal fluid

SPECT:

Single photon emission computed tomography

CM:

Cryptococcal meningitis

PML:

Progressive multifocal leukoencephalopathy

CMV:

Cytomegalovirus

CNS:

Central nervous system

PET:

Positron emission tomography

MRI:

Magnetic resonance imaging

CT:

Computed tomographyCCT Cranial computed tomography

References

  1. Grainger RG, Allison DJ. Diagnostic radiology, vol. 3. 3rd ed. London/New York: Churchill Livingstone Edinburgh; 1997. p. 2039–125.

    Google Scholar 

  2. Reeders JWAJ. Diagnostic imaging of AIDS. Stuttgart/New York: Georg Thieme Verlag Thieme Medical Publishers; 1992. p. 5–50.

    Google Scholar 

  3. Smith PR. Neuroradiology of intracranial infections. Pediatr Neurosurg. 1992;18(2):92–104.

    Article  CAS  PubMed  Google Scholar 

  4. Whelan MA, Kricheff I, Handler M. Acquired immuno deficiency syndrome: cerebral computed tomography manifestations. Radiology. 1983;149(2):477–84.

    Article  CAS  PubMed  Google Scholar 

  5. Grainger RG, Allison DJ. Diagnostic radiology, vol. 3. 3rd ed. London/New York: Churchill Livingstone Edinburgh; 1997. p. 2039–125.

    Google Scholar 

  6. Rosci MA, Pigorini F, Berbabei A, et al. Methods for detecting early signs of AIDS dementia complex in n asymptomatic HIV-in infected subjects. AIDS. 1992;6:1309–16.

    Article  CAS  PubMed  Google Scholar 

  7. Arendt G. Imaging methods as a diagnostic tool in neuro-AIDS. A review. Bildgebung. 1995;62(4):310–9.

    CAS  Google Scholar 

  8. Wyngaarden JB, Smith LH. Cecil textbook of medicine, vol. 2. 17th ed. Philadelphia/Tokyo: W.B. Saunders Company; 1976. p. 2054–60.

    Google Scholar 

  9. Lucas SB, Odida M, Wabinga H. The pathology of severe morbidity and mortality caused by HIV infection in Africa. AIDS. 1991;5:143–8.

    Google Scholar 

  10. Lucas S, Sewankambo N, Nambuya A, et al. The morbid anatomy of African AIDS. Basal: Karger; 1988. p. 123–33.

    Google Scholar 

  11. Oishi K, Mugerwa R, Mitarai S, et al. High mortality in AIDS patients with cryptococcal meningitis despite fluconazole therapy in Uganda. Int Conf AIDS. 1994;10(2):24 (Abstract no. 387B).

    Google Scholar 

  12. Baingana G, Katabira E, Hellman N. Neurologic disease in Uganda AIDS patients. Int Conf Aids. 1991;7(1):187 (Abstract No. M.B. 2021).

    Google Scholar 

  13. Baingana G, LeBlond RF, Sande M, et al. Clinical and laboratory features of cryptococcal meningitis in AIDS patients, Kampala, Uganda. Int Conf AIDS. 1992;8(2):B110 (Abstract No. PoB3139).

    Google Scholar 

  14. Baingana G, Grant R, Baingana B, et al. Predictors of survival among Ugandan AIDS patients with cryptococcal meningitis. Int Conf AIDS. 1993;9(1):368 (Abstracts no. PO-BO9-1399).

    Google Scholar 

  15. Kaisser G, et al. Neuor imaging of AIDS. Indiana Med. 1991;84(7):470–4.

    Google Scholar 

  16. Tso EL, Todd WC, et al. Cranial computed tomography in the emergency department evaluation of HIV – infected patients with neurologic complainants. Ann Emerg Med. 1993;22(7):1169–76.

    Article  CAS  PubMed  Google Scholar 

  17. Elkin CM, Leon E, Crenell SL, Leeds NE. Intracranial lesion in the acquired immune deficiency syndrome: radiological (computed tomography) features. JAMA. 1985;253(3):393–6.

    Article  CAS  PubMed  Google Scholar 

  18. Weisberg N. Cerebral computed tomography. A text-atlas. 3rd ed. Philadelphia/London: WB. Saunders Company; 1989. p. 290–318.

    Google Scholar 

  19. Anne-G, O. Hand book of neuroradiology. Mosby Year Book. 1991. p. 241–9.

    Google Scholar 

  20. Sutton D. A text books of radiology and imaging, vol. 2. 5th ed. Edinburgh/New York: Churchill Livingstone; 1980. p. 1499–577.

    Google Scholar 

  21. Post MDJ, Chan JC, Hensley GT, et al. Toxoplasma encephalitis in Haitian adult with acquired immune deficiency syndrome: clinical pathologic CT correlation. AJNR Am J Neuroradiol. 1983;140:861–6.

    CAS  Google Scholar 

  22. Krupp LB, Lipton RB, Swerdlow ML, et al. Progressive multifocal leukoencephalopathy: clinical and radiographic features. Ann Neurol. 1985;17:344–9.

    Article  CAS  PubMed  Google Scholar 

  23. Navia BA, Petito CK, Gold JWM, et al. Cerebral toxoplasmosis complicating the acquired immunodeficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol. 1986;19:224–8.

    Article  CAS  PubMed  Google Scholar 

  24. Post MJD, Tate LG, Quencer RM, et al. CT, MR and pathology in HIV encephalitis and meningitis. AJR Am J Roentgenol. 1988;151:373–80.

    Article  CAS  Google Scholar 

  25. Poon T, Matoso I, Tcherthoff V, et al. CT features of primary cerebral lymphoma in AIDS and Non – AIDS patients. J Comput Assist Tomogr. 1989;13:6–9.

    Article  CAS  PubMed  Google Scholar 

  26. Spider WD, Simpson DM, Melson S, et al. Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol. 1983;14:403–18.

    Article  Google Scholar 

  27. Pinto AN. AIDS and cerebrovascular disease. Stroke. 1996;27(3):538–43.

    Article  CAS  PubMed  Google Scholar 

  28. Levy RM, Bredesen DE, Rosenblum ML. Neurological manifestation of acquired immune deficiency syndrome AIDS: a review of 200 cases. AJNR Am J Neuroradiol. 1986;7:833–9.

    Google Scholar 

  29. Coyle TE. Hematologic complications of human immunodeficiency virus infection and the acquired immunodeficiency syndrome. Med Clin North Am. 1997;81(2):449–70.

    Article  CAS  PubMed  Google Scholar 

  30. Harbol AW, Liesveld JL, Simpson-Haidaris PJ, Abbound CN. Mechanism of cytopenia in human immunodeficiency virus infection. Blood Rev. 1994;81(2):449–70.

    Google Scholar 

  31. Mugerwa RD, Marum LH, Serwadda D. Human immuno deficiency virus and AIDS in Uganda. East Afr Med J. 1996;73(1):20–6.

    CAS  PubMed  Google Scholar 

  32. Mugyenyi P, Mugerwa R, Loughlin A et al. HIV-I seroprevalence and incidence in 3 Ugandan military cohorts over time. Conf Adv AIDS Vaccine Dev. 1996: Feb 11–15:299 (Poster 109).

    Google Scholar 

  33. Mugenyi P, Hom D, Loughlin A, Johnson J, et al. HIV-1 seroprevalence, incidence and risk behavior in the Ugandan military. Int Conf AIDS. 1996;11(1):139 (Abstract no Mo.C. 1483).

    Google Scholar 

  34. Wawer MJ, Sewankambo NK, Gray RH. Trends in crude prevalence may not reflect incidence in communities with mature epidemics. Int Conf AIDS. 1994;10(1):84 (Abstract No. 289 C).

    Google Scholar 

  35. Kangeya-Kayondo JF, Kamali A, Nunn AJ, et al. Incidence of HIV-Infection in adults and socio-demographic characteristics of sero converters in a rural population in Uganda: 1990–94. Int J Epidemiol. 1996;25:1077–82.

    Article  Google Scholar 

  36. Nunn AJ, Wagner H, Okongo JM, et al. HIV-1 infection in a Uganda town of the trans-African highway: prevalence and risk factors. Int J STD AIDS. 1996;7(2):123–30.

    Article  CAS  PubMed  Google Scholar 

  37. De Cock K, Soro B, Coulibaly I, Lucas S. Tuberculosis and HIV infection in sub-Saharan Africa. JAMA. 1992;268:1581–7.

    Article  Google Scholar 

  38. Wabinga HR, Parkin DM, Wabwire MF, Mugerwa JW. Cancer in Kampala, Uganda, in 1989–91: changes in incidence in the era of AIDS. Int J Cancer. 1993;54(1):26–36.

    Article  CAS  PubMed  Google Scholar 

  39. Safai B, Lynfield R, Lowenthal DA, et al. Cancers-Associated with HIV infection. Anti Cancer Reg. 1978;7:1055–67.

    Google Scholar 

  40. Centers for Disease Control. Update: acquired immune deficiency syndrome (AIDS) worldwide. MMWR Morb Mortal Wkly Rep. 1988;37:286–95.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Mulago National Referral Hospital, Kampala, Uganda

    Rosemary Kusaba Byanyima

Authors
  1. Rosemary Kusaba Byanyima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rosemary Kusaba Byanyima .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, Makerere University Medical School, Kampala, Uganda

    Seggane Musisi

  2. Dept. Anatomy & Cellular Biology, Tufts University School of Medicine, Boston, Massachusetts, USA

    Stanley Jacobson

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Byanyima, R.K. (2015). CT Findings in the Brain of Adult Patients with HIV/AIDS. In: Musisi, S., Jacobson, S. (eds) Brain Degeneration and Dementia in Sub-Saharan Africa. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2456-1_15

Download citation

Publish with us

Policies and ethics

Search

Navigation