title: Bilateral pallidal hemorrhage in toxoplasmosis update of acute symmetric lesions of deep nuclei.
abstract: As acute symmetric lesions of deep gray nuclei are often associated with an impaired level of consciousness and neuroimaging by itself cannot distinguish between etiologies, diagnosis may be problematic. Appreciation of the cause of the various neuroimaging patterns in conjunction with the history, examination and laboratory investigations allows for accurate diagnosis in the vast majority of cases. Given the metabolic vulnerability of deep gray nuclei, other than bi-thalamic infarction, it follows that toxic-metabolic and hypoxic-ischemic events account for the majority of cases. Nevertheless, the differential diagnosis is broad and diverse. We here describe two cases of bilateral pallidal hemorrhage in AIDS-associated toxoplasmosis, and review conditions recently described with acute symmetric deep gray nuclei lesions on neuroimaging.
authors.affiliation: Department of Neurology, Hartford Hospital and University of Connecticut School of Medicine, USA pfinell@harthosp.org.
authors.forename: Pasquale F
authors.initials: PF
authors.lastname: Finelli
authors.affiliation: Department of Radiology, Hartford Hospital and University of Connecticut School of Medicine, USA.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Wrubel
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000981:Antiprotozoal Agents
keywords: Deep gray nuclei; globus pallidus; magnetic resonanceMR imaging; toxoplasmosis