Intracranial Lesions in the Acquired Immunodeficiency Syndrome

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Abstract
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%.1Most patients present withPneumocystis cariniipneumonia 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) includeToxoplasma gondii,4Cryptococcus neoformans,4papovavirus,5Candida albicans,2cytomegalovirus,1Mycobacterium tuberculosis,6Aspergillis fumigatus,3and possiblyMycobacterium avium-intracellulare.2Primary CNS lymphoma,7secondary involvement of the CNS by systemic lymphoma,2plasmacytoma,2and Kaposi's sarcoma8constitute the usual neoplasms observed in AIDS. Thrombocytopenia in patients with AIDS predisposes them to cerebral hemorrhage, while nonbacterial thrombotic endocarditis results