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. 2004 Jun 29;10(2):137-43.
doi: 10.1177/159101990401000206. Epub 2004 Oct 22.

Arterial dissection and subarachnoid haemorrhage in human immunodeficiency virus-infected patients. A report of three cases

A Taylor  1 , D Lefeuvre, A Levy, S Candy
Affiliations

Arterial dissection and subarachnoid haemorrhage in human immunodeficiency virus-infected patients. A report of three cases

A Taylor et al. Interv Neuroradiol. .

Abstract

Cerebrovascular complications of AIDS have been reported as high as 34% in post mortem series. Most patients suffer from ischaemic strokes but there are a number of reports of patients presenting with subarachnoid haemorrhage (SAH) related specifically to aneurysm rupture. We present three patients with advanced HIV disease and low CD4 counts who present with SAH. In two of the patients the haemorrhage appeared to be caused by intracranial artery dissection which, to our knowledge, has not previously been described. Both patients were successfully treated endovascularly, one with segmental vessel trapping and the other with partial coil embolization of a false aneurysm. The pathological basis for HIV related arteriopathy is discussed in relation to these cases.

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Figures

Figure 1
Figure 1
T1 weighted MRI showing subacute blood clot in the region of the left vertebral artery.
Figure 2
Figure 2
Left vertebral AP view showing a small false aneurysm at the origin of the falx cerebelli artery (star) and dilatation of the right AICA (arrow).
Figure 3
Figure 3
Left vertebral lateral view showing stenosis and dilatation of the falx cerebelli artery origin.
Figure 4
Figure 4
Right internal carotid artery AP view showing carotid siphon dilated arteriopathy.
Figure 5
Figure 5
GDC placement in the left vertebral artery.
Figure 6
Figure 6
Three month control angiogram showing vertebral artery recanalisation and false aneurysm healing.
Figure 7
Figure 7
AP view of the right internal carotid artery with a false aneurysm of the A1 proximal vessel.
Figure 8
Figure 8
Lateral view of the small false aneurysm.
Figure 9
Figure 9
Single 2 mm coil in the false aneurysm with preservation of the A1 vessel.
Figure 10
Figure 10
Contrast enhanced CT scan showing dilated cerebral vessels.
Figure 11
Figure 11
MRA with dilated arteriopathy of medium sized arteries.
Figure 12
Figure 12
Left carotid angiogram showing dilated arteriopathy of the middle cerebral artery branches.
See this image and copyright information in PMC

References

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