Contrasting Cases of HIV Vasculopathy Associated Fusiform Aneurysms. (January 2023)

• Record Type: Journal Article
• Authors: Kyle, Kevin; Maher, Mary; Achhra, Amit C.; Venna, Nagagopal
• Is Part Of: Neurohospitalist. Volume 13:Number 1(2023)
• Page Start: 69
• Page End: 73
• Publication Date: 2023-01
• Subjects: HIV Vasculopathy -- fusiform aneurysm -- moyamoya; Nervous system -- Diseases -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1177/19418744221122863
• Languages: English
• ISSNs: 1941-8744

Abstract

Background: Human Immunodeficiency Virus (HIV) vasculopathy encompasses the development of aneurysms, stenosis and vessel occlusions. Intracranial fusiform aneurysms in Human Immunodeficiency Virus (HIV) were originally described in children; however, HIV-associated aneurysms are increasingly recognized in adults.Purpose: We present two cases to highlight the spectrum of severity and outline instructive clinical courses. Results: Case one is a 52-year-old woman with HIV, Acquired Immunodeficiency Syndrome (AIDS)-defining progressive multifocal leukoencephalopathy (PML) and an 18 years course of cerebral aneurysms, aneurysm thrombosis and the development of right middle cerebral artery (MCA) moyamoya pattern collaterals. Case two is a 55-year-old man with AIDS-defining cerebral toxoplasmosis, complicated by IRIS and anterior and posterior circulation fusiform aneurysm formation.Conclusions: The combination of both fusiform abnormalities and Moyamoya, discussed in our first case has not been previously described. In comparison, our second case actually demonstrated improvement in vasculopathy after nine-months of antiretroviral therapy (ART) adherence.