Acute/subacute cerebral infarction (ASCI) in HIV-negative adults with cryptococcal meningoencephalitis (CM): a MRI-based follow-up study and a clinical comparison to HIV-negative CM adults without ASCI.
BACKGROUND
Acute/subacute cerebral infarction (ASCI) in HIV-negative cryptococcal meningoencephalitis (CM) adults has rarely been examined by a series of MRI-based follow-up study. We studied a series of MRI follow-up study of CM adults and compared the clinical characters of those with ASCI and those without ASCI.


METHODS
The clinical characteristics and a series of brain MRI findings of seven CM adults with ASCI were enrolled for analysis. The clinical characteristics of another 30 HIV-negative CM adults who did not have ASCI were also included for a comparative analysis.


RESULTS
The seven HIV-negative CM adults with ASCI were four men and three women, aged 46-78 years. Lacunar infarction was the type of ASCI, and 86% (6/7) of the ACSI were multiple infarctions distributed in both the anterior and posterior cerebrovascular territories. The seven CM patients with ASCI were significantly older and had a higher rate of DM and previous stroke than the other 30 CM adults without ASCI. They also had a higher incidence of consciousness disturbance at presentation and had a poor prognosis.


CONCLUSIONS
ASCI was found in 18.9% (7/37) of HIV-negative CM adults. Serial MRI follow-up studies may allow a better delineation of ASCI in this specific group of infectious disease and multiple lacunar infarctions was the most common type. Older in age and presence of DM and previous stroke were the significant underlying conditions. CM patients with ASCI also had a poor therapeutic outcome.
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niaosung, Kaohsiung 833, Taiwan.
Shu-Fang
SF
Chen
Cheng-Hsien
CH
Lu
Chun-Chung
CC
Lui
Chi-Ren
CR
Huang
Yao-Chung
YC
Chuang
Teng-Yeow
TY
Tan
Nai-Wen
NW
Tsai
Chiung-Chih
CC
Chang
Wan-Chen
WC
Tsai
Wen-Neng
WN
Chang
D000368:Aged; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D018023:HIV Seronegativity; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
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