Evaluation and management of intracranial mass lesions in AIDS: Report of the Quality Standards Subcommittee of the American Academy of Neurology

Gildenberg, Philip L.

doi:10.1212/wnl.51.4.1232-c

Cited by 7 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The current guidelines for diagnosis of intracranial lesions state that T1 SPECT is an option when available. When positive (marked uptake in contrast to toxoplasma), it appears to be highly specific for primary CNS lymphoma [6, 8]. These guidelines have been described as helpful [3] in spinal cord lesions and suspected lymphoma, although specific guidelines for spinal cord lesions are not presently available.…”

Section: Discussionmentioning

confidence: 99%

“…Empiric treatment for toxoplasmosis with oral pyrimethamine and sulfadiazine (with folinic acid) has been recommended in all cases of intracranial mass lesions in patients with HIV/AIDS (except in a solitary mass with negative toxoplasma serology) [6]. It is also believed to be beneficial when there is spinal cord involvement [2].…”

Section: Discussionmentioning

confidence: 99%

“…If the lesions remain unchanged or progress, the diagnosis has to be reconsidered and the therapeutic strategy reevaluated. In cases of atypical large solitary toxoplasma lesions resembling lymphoma (that also present with spinal cord enlargement), additional diagnostic modalities should be performed [3, 6]. Due to the immunosuppressant effects of steroids [9], the optimal dosage and period of treatment for spinal cord lesions must be addressed in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of myelopathy may be as high as 20%, with 50% of the cases reported post-mortem [3, 5]. Toxoplasmosis is the most common cause of intracranial lesions responsible for neurological deficits in AIDS patients, occurring in 3–10% of patients in the United States and in up to 50% of AIDS patients in Europe, Latin America, and Africa [6, 10]. A review of existing literature suggests that although Toxoplasmic myelitis is uncommon, it should be suspected in immunocompromised patients who present with symptoms of acute or sub-acute myelopathy [7].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

et al. 2010

View full text Add to dashboard Cite

Approximately 10% of patients with AIDS present with some neurological deficit as their initial complaint, and up to 80% will have CNS involvement during the course of their disease. Toxoplasmosis is the most common cause of cerebral mass lesions in patients with AIDS, but appears to be an uncommon cause of spinal cord disease. The incidence of myelopathy may be as high as 20%, with 50% of the cases reported post-mortem. We present a unique case of spinal cord disease as the initial presentation of AIDS. We also present a comprehensive literature review of this topic, its diagnosis and treatment. This is a retrospective chart review case report. After a detailed case presentation, several diagnostic and therapeutic aspects of this unique case are thoroughly discussed. Although spinal cord toxoplasmosis is uncommon, it has been suggested that most patients with AIDS that present with evolving myelopathy, characterized by extremity weakness, sensory involvement, spinal cord enlargement, enhancing lesions in brain or spinal cord CT or MRI, have toxoplasmic myelitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Although other causes of hydrocephalus in HIV have been reported, none of these reports met our criteria for inclusion. [5][6][7][8]96,97 Understanding how outcomes differ following VPS insertion in HIV-infected and non-infected patients with causes of hydrocephalus not directly attributable to HIV infection (e.g. subarachnoid haemorrhage, Chiari malformation, etc) would allow determination of the relative impacts of undertaking VPS in the context of active CSF infection and HIV-infection.…”

Section: Suggestions For Future Researchmentioning

confidence: 99%

Ventriculoperitoneal shunt insertion in human immunodeficiency virus infected adults: a systematic review and meta-analysis

Loan

Poon

Tominey

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Hydrocephalus is a common, life threatening complication of human immunodeficiency virus (HIV)-related central nervous system opportunistic infection which can be treated by insertion of a ventriculoperitoneal shunt (VPS). In HIV-infected patients there is concern that VPS might be associated with unacceptably high mortality. To identify prognostic indicators, we aimed to compare survival and clinical outcome following VPS placement between all studied causes of hydrocephalus in HIV infected patients.Methods The following electronic databases were searched: The Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), EMBASE, CINAHL Plus, LILACS, Research Registry, the metaRegister of Controlled Trials, ClinicalTrials.gov, African Journals Online, and the OpenGrey database. We included observational studies of HIV-infected patients treated with VPS which reported of survival or clinical outcome. Data was extracted using standardised proformas. Risk of bias was assessed using validated domain-based tools. Results 723 unique study records were screened. Nine observational studies were included. Three included a total of 75 patients with tuberculous meningitis (TBM) and six included a total of 49 patients with cryptococcal meningitis (CM). All of the CM and two of the TBM studies were of weak quality. One of the TBM studies was of moderate quality. One-month mortality ranged from 62.5-100% for CM and 33.3-61.9% for TBM. These pooled data were of low to very-low quality and was inadequate to support meta-analysis between aetiologies. Pooling of results from two studies with a total of 77 participants indicated that HIV-infected patients with TBM had higher risk of one-month mortality compared with HIV non-infected controls (odds ratio 3.03; 95% confidence-interval 1.13- 8.12; p=0.03). Conclusions The evidence base is currently inadequate to inform prognostication in VPS insertion in HIV-infected patients. A population-based prospective cohort study is required to address this, in the first instance.

show abstract

Neurobehavioral Complications of HIV Infection

Marcotte

Grant

Atkinson

et al. 2001

Medical Neuropsychology

View full text Add to dashboard Cite

Evaluation and management of intracranial mass lesions in AIDS: Report of the Quality Standards Subcommittee of the American Academy of Neurology

Cited by 7 publications

References 11 publications

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature

Ventriculoperitoneal shunt insertion in human immunodeficiency virus infected adults: a systematic review and meta-analysis

Neurobehavioral Complications of HIV Infection

Contact Info

Product

Resources

About