title: Neurologic emergencies in HIV-negative immunosuppressed patients.
abstract: HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response. Infectious disease is the first diagnostic suspicion, and the identification of an opportunistic pathogen should be oriented in function of the type and degree of immunosuppression. Other neurologic emergencies include ischemic stroke, cerebral hemorrhage, neoplastic processes, and pharmacological neurotoxicity. This article reviews the role of neuroimaging in HIV-negative immunodepressed patients with a neurologic complication that requires urgent management.
authors.affiliation: Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, España; CIBER de Salud Mental (CIBERSAM), Madrid, España. Electronic address: jguzman.hgugm@salud.madrid.org.
authors.forename: J A
authors.initials: JA
authors.lastname: Guzmán-De-Villoria
authors.affiliation: Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: Fernández-García
authors.affiliation: Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: P J
authors.initials: PJ
authors.lastname: Borrego-Ruiz
mesh_terms: D000465:Algorithms; D002494:Central Nervous System Infections / Q000000981:diagnostic imaging / Q000628:therapy; D004630:Emergencies; D018023:HIV Seronegativity; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D009422:Nervous System Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D059906:Neuroimaging
keywords: Central nervous system; Complicación neurológica; Emergency; Fármacos inmunosupresores; Ictus; Imagen por resonancia magnética; Immunosuppression; Immunosuppressive drugs; Infecciones oportunistas; Inmunosupresión; Magnetic resonance imaging; Neuroimagen; Neuroimaging; Opportunistic infections; Organ transplantation; Sistema nervioso central; Stroke; Trasplante de órganos; Urgencia