CNS manifestation of AIDS

1-Important rule:

-Usually the CNS changes of AIDS are infectious or neoplasms.

-When you are facing a case of AIDS with CNS manifestation think only in two diseases which are the toxoplasma and lymphoma.

-Remember that the radiological appearance in the patient with AIDS differs than that in the other patient with normal immune state, in case of suppressed immune patient, the radiological signs differs completely and becomes exaggerated.
-So it is very difficult to differentiate between toxoplasma and lymphoma which lead finally to ask for biopsy.

Ordinary appearance of toxoplasma

A hypo intense lesion is seen in the right basal ganglia region with massive amount of surrounding edema in a patient with AIDS, picture suggestive of toxoplasma versus lymphoma for biopsy.

2-AIDS Dementia Complex:

-Occurs in patient with AIDS.
-Middle age.
-Shows white matter changes.

3-Progressive Multi focal Leukoencephalopathy:  


-Seen in AIDS.
-White matter lesion.
*Special location in the posterior parietal area near ventricles.
*Could be unilateral or bilateral.
*3 NO
No edema.
No mass effects.
No enhancement.


-D.D. with AIDS encephalitis.