Stroke in pediatric acquired immunodeficiency syndrome

Yong D. Park, Anita L. Belman, Tae‐Seung ‐S Kim, Katsuhiro Kure, Josefina F. Llena, George Lantos, Larry Bernstein, Dennis W. Dickson

Research output: Contribution to journalArticle

154 Scopus citations

Abstract

In a 4½‐year period, 4 of 68 children in a longitudinal study of neurological complications of human immunodeficiency virus (HIV) infection had clinical and/or neuroradiological evidence of stroke, yielding a clinical incidence of stroke in this population of 1.3% per year. During this period, 32 subjects died, and permission for autopsy was granted in 18 of the patients, including 3 of 4 who had clinical evidence of stroke. The prevalence of cerebrovascular pathological features in our consecutive autopsy series was higher than the clinical incidence. At autopsy cerebrovascular disease was documented in 6 (24%) of 25 children with HIV infection, including all 3 children who had clinical evidence of stroke. Four patients had intracerebral hemorrhages, 6 patients had nonhemorrhagic infarcts, and 3 had both. Hemorrhage was catastrophic in 1 child and clinically silent in 3 children, all of whom had immune thrombocytopenia. One child had an arteriopathy that affected meningocerebral arteries. In another child, the arteries of the circle of Willis were aneurysmally dilated. Two children had coexisting cardiomyopathy and subacute necrotizing encephalomyelopathy with vascular proliferation. These results suggest that stroke should be considered when children with HIV infection develop focal neurological signs.

Original languageEnglish (US)
Pages (from-to)303-311
Number of pages9
JournalAnnals of Neurology
Volume28
Issue number3
DOIs
StatePublished - Sep 1990
Externally publishedYes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Park, Y. D., Belman, A. L., Kim, TS. S., Kure, K., Llena, J. F., Lantos, G., Bernstein, L., & Dickson, D. W. (1990). Stroke in pediatric acquired immunodeficiency syndrome. Annals of Neurology, 28(3), 303-311. https://doi.org/10.1002/ana.410280302