Skip to main content
Log in

Cerebrovascular lesions in acquired immune deficiency syndrome (AIDS)

  • Regular Papers
  • Published:
Acta Neuropathologica Aims and scope Submit manuscript

Summary

Cerebrovascular lesions were seen in 28 of 83 cases (34%) of acquired immune deficiency syndrome (AIDS). Cerebral hemorrhage was noted in 4 cases, cerebral infarct in 23 cases and both in 1 case. Cerebral hemorrhage was in various locations such as intraparenchymal, subarachnoid space, subdural space and epidural space. Large, clinically evident hemorrhage was noted in 2 of 5 cases and bleeding tendency was noted in 2 cases. Most of the 24 cases with cerebral infarcts were not clinically evident; they were multiple, small and mainly involved the striatum, cerebral cortex and brain stem. Mural thickening of occasional small blood vessels was seen in 12 of the cases (50%) with infarcts. Other changes in blood vessels included vasculitis in one cases and perivascular lymphocytic infiltration in another. In addition to thrombo-embolism and systemic ischemia/anoxia, these blood vessel changes may have a role in the development of cerebral infarcts in AIDS.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Anders KH, Guerra WF, Tomiyasu U, Verity MA, Vinters HV (1986) The neuropathology of AIDS. UCLA experience and reviews. Am J Pathol 124:537–558

    Google Scholar 

  2. Belman AL, Lantos G, Horoupian D, Novick BE, Ultman MH, Dickson DW, Rubinstein A (1986) AIDS: calcification of the basal ganglia in infants and children. Neurology 36:1192–1199

    Google Scholar 

  3. Brierly JB, Graham DI (1984) Hypoxia and vascular disorders of the central nervous system. In: Adams JH, Corsellis JAN, Duchen LW (eds) Greenfield's neuropathology, 4th edn. Arnold, London, pp 125–156

    Google Scholar 

  4. Brust JCM (1986) Stroke and substance abuse. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM (eds) Stroke. Pathophysiology, diagnosis and management, vol 2. Livingstone, New York, pp 903–917

    Google Scholar 

  5. Budka H, Costanzi G, Cristini S, Lechi A, Parravicini C, Trabattoni R, Vago L (1987) Brain pathology induced by infection with the human immunodeficiency virus (HIV). A histological, immunocytochemical and electron microscopical study of 100 autopsy cases. Acta Neuropathol (Berl) 75:185–198

    Google Scholar 

  6. Cammarosano C, Lewis W (1985) Cardiac lesions in acquired immune deficiency syndrome (AIDS). J Am Coll Cardiol 5:703–706

    Google Scholar 

  7. Caplan LR, Hier DB, Banks G (1982) Current concepts of cerebrovascular disease — stroke: stroke and drug abuse. Stroke 13:869–872

    Google Scholar 

  8. Cho E-S, Sharer LR, Reress NS, Little B (1987) Intimal proliferation of leptomeningeal arteries and brain infarcts in subjects with AIDS. J Neuropathol Exp Neurol 46:385

    Google Scholar 

  9. Monte SM de la, Ho DD, Schooley RT, Hirsch MS, Richardson EP Jr (1987) Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection. Neurology 37:562–569

    Google Scholar 

  10. Epstein LG, Sharer LR, Joshi VV, Fojas MM, Koenigsberger MR, Oleske JM (1985) Progressive encephalopathy in children with acquired immune deficiency syndrome. Ann Neurol 17:488–496

    Google Scholar 

  11. Garcia I, Fainstein V, Rios A, Luna M, Mansell P, Reuben J, Hersh (1983) Nonbacterial thrombotic endocarditis in a male homosexual with Kaposi's sarcoma. Arch Intern Med 143:1243–1244

    Google Scholar 

  12. Guarda LA, Luna MA, Smith JL, Mansell PWA, Gyorkey F, Roca AN (1984) Acquired immune deficiency syndrome: postmortem findings. Am J Clin Pathol 81:549–557

    Google Scholar 

  13. Ho DD, Pomerantz RJ, Kaplan J (1987) Pathogenesis of infection with human immunodeficiency virus. N Engl J Med 317:278–286

    Google Scholar 

  14. Kato T, Hirano A, Llena JF, Dembitzer HM (1987) Neuropathology of AIDS in 53 autopsy cases with particular emphasis on microglial nodules and multinucleated giant cells. Acta neuropathol (Berl) 73:287–294

    Google Scholar 

  15. Koeppen AH, Lansing LS, Peng S-K, Smith RS (1981) Central nervous system vasculitis in cytomegalovirus infection. J Neurol Sci 51:395–410

    Google Scholar 

  16. Leestma JE (1985) Viral infections of the nervous system. In: Davis RL, Robertson DM (eds) Textbook of neuropathology. Williams and Wilkins, Baltimore, pp 704–787

    Google Scholar 

  17. Levy RM, Bredesen DE, Rosenblum ML (19850 Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg 62:475–495

    Google Scholar 

  18. Morgello S, Cho E-S, Nielsen S, Denvinsky O, Petito CK (1987) Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: an autopsy study of 30 cases and a review of the literature. Hum Pathol 18:289–297

    Google Scholar 

  19. Moskowitz LB, Hensley GT, Chan JC, Gregorios J, Conley FK (1984) The neuropathology of acquired immune deficiency syndrome. Arch Pathol Lab Med 108:867–872

    Google Scholar 

  20. Navia BA, Cho E-S, Petito CK, Price RW (1986) The AIDS dementia complex. II. Neuropathology. Ann Neurol 19:525–535

    Google Scholar 

  21. Navia BA, Petito CK, Gold JWM, Cho E-S, Jordan BD, Price RW (1986) Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. Ann Neurol 19:224–238

    Google Scholar 

  22. Parker JC Jr, Dyer ML (1985) Neurologic infections due to bacteria, fungi and parasites. In: Davis RL, Robertson DM (eds) Textbook of neuropathology. Williams and Wilkins, Baltimore, pp 632–703

    Google Scholar 

  23. Pearson J, Richtr RW (1979) Addiction to opiates: neurologic aspects. In: Vinken P, Bruyn G (ed) Intoxication of the nervous system. Part II. North-Holland, Amsterdam, pp 593–560 (Handbook of clinical neurology, vol 37)

    Google Scholar 

  24. Petito CK, Cho E-S, Lemann W, Navia BA, Price RW (1986) Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review. J Neuropathol Exp Neurol 46:635–646

    Google Scholar 

  25. Pumarola-Sune T, Navia BA, Cordon-Cardo C, Cho E-S, Price RW (1987) HIV antigen in the brains of patients with the AIDS dementia complex. Ann Neurol 21:490–496

    Google Scholar 

  26. Sharer LR, Kapila R (1985) Neuropathologic observations in acquired immunodeficiency syndrome (AIDS). Acta Neuropathol (Berl) 66:188–198

    Google Scholar 

  27. Sharer LR, Epstein LG, Cho E-S, Joshi VV, Meyenhofer MF, Rankin LF, Petito CK (1986) Pathologic features of AIDS encephalopathy in children: evidence for LAV/HTLV-III infection of brain. Hum Pathol 17:271–284

    Google Scholar 

  28. Snider WD, Simpson DM, Nielsen S, Gold JWM, Metroka CE, Posner JB (1983) Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol 14:403–418

    Google Scholar 

  29. Steegman AT (1968) The neuropathology of cardiac arrest. In: Minkler J (eds) Pathology of the nervous system, vol 1. McGraw-Hill, New York, pp 1005–1029

    Google Scholar 

  30. Ward JM, O'Leary TJ, Baskin GB, Benveniste R, Harris CA, Nara PL, Rhodes RH (1987) Immunohistochemical localization of human and simian immunodeficiency viral antigens in fixed tissue sections. Am J Pathol 127:199–205

    Google Scholar 

  31. Wiley CA, Schrier RD, Denaro FJ, Nelson JA, Lampert PW, Oldstone MBA (1986) Localization of cytomegalovirus proteins and genome during fulminant central nervous system infection in an AIDS patient. J Neuropathol Exp Neurol 45:127–139

    Google Scholar 

  32. Wiley CA, Schrier RD, Nelson JA, Lampert PW, Oldstone MBA (1986) Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency syndrome patients. Proc Natl Acad Sci USA 83:7089–7093

    Google Scholar 

  33. Yankner BA, Skolnik PR, Shoukimas GM, Gabuzda DH, Sobel RA, Ho DD (1986) Cerebral granulomatous angiitis associated with isolation of human T-lymphotropic virus type III from the central nervous system. Ann Neurol 20:362–364

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mizusawa, H., Hirano, A., Llena, J.F. et al. Cerebrovascular lesions in acquired immune deficiency syndrome (AIDS). Acta Neuropathol 76, 451–457 (1988). https://doi.org/10.1007/BF00686383

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00686383

Key words

Navigation