title: Human immunodeficiency virus-associated stroke: an aetiopathogenesis study.
abstract: OBJECTIVE
  To describe the nature of human immunodeficiency virus (HIV) associated stroke and further establish its etiopathogenesis
  
  
  METHODS
  A retrospective study of 19 patients of HIV associated stroke, admitted in Regional Institute of Medical Sciences, Imphal between November 2010 and November 2011. History was taken stressing importance on mode of transmission of HIV, risk factors for stroke, antiretroviral treatment (ART) and regimen. All necessary haematological, serological and neuroradiological investigations, cerebrospinal fluid (CSF) examination were undertaken in relevant cases. A final diagnosis of stroke aetiology was made with the corroborative evidence of clinical examination and investigational data.
  
  
  RESULTS
  Out of the 19 patients of Stroke in HIV, male-female ratio was 1.1:1.The mean age at presentation was 39.47 +/- 8.1 yrs (Range 28-60). Only 3 (15.78%) patients were on ART and other 16 (84.42%) patients were ART naive. In 15 out of 1.9 patients (78.94%) stroke was the first presentation of HIV infection. 3 patients (16.67%) had recurrent cerebrovascular accident (CVA). Computerised tomography (CT) Brain revealed Infarction in 17 patients (89.47%), 1 patient (5.26%) had Haemorrhage and 1 patient (5.26%) had both haemorrhage and infarction. 9 (47.36%) patients had an associated opportunistic infection (OI) in the central nervous system (CNS). In 52.64% patients who had no Ols in the CNS, further work up revealed no aetiology in 3 cases (15.78%) and Indeterminate aetiology (HIV associated coagulopathy and HIV vasculopathy) in 7 (36.84%) patients. Mean CD4 cell count in HIV and Stroke patients was found to be 178.3 +/- 115.38 cells/mm3.
  
  
  CONCLUSIONS
  Stroke is being reported more often as the first presentation of HIV infection. Thus it is worthwhile to screen for HIV infection in the work up for stroke in the young, and after confirmation of HIV infection, should further proceed to establishing an aetiopathogenesis for Stroke in HIV.
authors: G
authors: G
authors: Arvind
authors: Synrem
authors: S
authors: Evangelyne
authors: A
authors: A
authors: Limanukshi
authors: S Bhagyabati
authors: SB
authors: Devi
authors: W Jatishwor
authors: WJ
authors: Singh
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications; D000328:Adult; D020520:Brain Infarction / Q000150:complications; D018791:CD4 Lymphocyte Count; D002494:Central Nervous System Infections / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology*