J Korean Soc Radiol.  2019 Jan;80(1):157-163. 10.3348/jksr.2019.80.1.157.

Human Immunodeficiency Virus-Associated Multiple Cerebral Aneurysmal Vasculopathy in a Young Adult: A Case Report

• Kim D
• Baek JW
• Heo YJ
• Jeong HW

• KMID: 2442477
• DOI: http://doi.org/10.3348/jksr.2019.80.1.157

Abstract

Human immunodeficiency virus (HIV)-associated vasculopathy comprises several forms of arteriopathy without evidence of a secondary cause. HIV-associated cerebral aneurysmal vasculopathy is a rare condition, but is being increasingly recognized. Herein, we report a case of HIV-associated multiple cerebral aneurysmal vasculopathy with cerebral infarction in a young adult.

MeSH Terms

Aneurysm
Cerebral Infarction
HIV
Humans*
Intracranial Aneurysm*
Vascular Diseases
Young Adult*

Figure

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  Fig. 1. HIV-associated multiple cerebral aneurysmal vasculopathy in a 34-year old man, presenting with left side weakness and tingling sensation in left leg and cheek. A. MRI demonstrates subacute infarction in the right thalamus. The lesion shows high signal intensity in the diffusion weighted image (left upper panel) without remarkable signal change on apparent diffusion coefficient map (right upper panel), high signal intensity in the fluid attenuation inversion recovery images (left lower panel), and subtle heterogeneous contrast enhancement (right lower panel).

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  Fig. 1. HIV-associated multiple cerebral aneurysmal vasculopathy in a 34-year old man, presenting with left side weakness and tingling sensation in left leg and cheek. B. 3-dimensional time-of-flight MRI reveals stenosis at right A2 (arrow in left panel) and P2 segment (arrow in right panel). C. Right internal carotid artery (left panel), left internal carotid artery (center panel), and right vertebral artery (right panel) angiograms show multifocal stenosis (arrows) and aneurysmal dilatation (arrowheads) involving right A2, branch of A2, branch of left A2, right anterior inferior cerebellar artery, and right P2.

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  Fig. 1. HIV-associated multiple cerebral aneurysmal vasculopathy in a 34-year old man, presenting with left side weakness and tingling sensation in left leg and cheek. D. Sagittal contrast-enhanced T1 plaque MRI (upper panel) after 3 months reveals eccentric wall thickening with enhancement of stenotic right M1 (white arrow) and M2 (black arrow). 3-dimensional time-of-flight MRI (lower panel) reveals new stenotic lesions in right M1 (white arrow) and partially improved stenotic lesions in right P2 (black arrowhead).

Reference

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