Published in:
13-12-2022 | Vasculitis | Case Report
HIV-associated multiple intracranial aneurysms and stroke in an adult patient: successful treatment with a combination of glucocorticoid and antiviral agents
Authors:
Mohsen Soltani Sabi, Pourandokht Mousavian, Payam Sasannejad, Leila Afshar Hezarkhani, Nasrin Salimnia, Mahsa Akbari Oryani, Mohammadreza Malekzadeh, Hamidreza Moosavian
Published in:
Journal of NeuroVirology
|
Issue 1/2023
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Abstract
A 35-year-old Iranian man with an 18-year history of human immunodeficiency virus (HIV) infection developed sudden left-sided hemiparesis and mild dysarthria. Based on laboratory results, brain and neck computerized tomography angiography (CTA), echocardiography, hypercoagulability tests, and vasculitis tests, the patient was diagnosed with a stroke with multiple intracranial aneurysms secondary to HIV. Cerebral aneurysms and stroke are uncommon in HIV-infected patients, and the aneurysms’ exact cause and risk factors are unknown. There is currently no effective regimen or definitive treatment for HIV-associated vasculitis. In the present study, the patient recovered without any neurological deficits following treatment with oral prednisolone, combined with combination antiretroviral therapy (cART), valacyclovir, and antiplatelet medication. Furthermore, after 2 months of immunosuppressive treatment, all imaging abnormalities improved, and no new events were observed at the 20-month follow-up. To the best of our knowledge, this is the first case in which a patient with HIV-associated vasculopathy and stroke has survived successfully, and all angiographic abnormalities completely eliminated.