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Clinical Neuroradiology

, Volume 28, Issue 3, pp 357–365 | Cite as

Considerations on the Relevance of Cerebral Fusiform Aneurysms Observed During HIV Infection

  • Bruno Law-ye
  • Robert-Yves Carlier
  • Raphaël Richard
  • Raphaël Blanc
  • Claire Jourdan
  • Pierre de Truchis
  • Flore Viry
  • Didier Dormont
  • Delphine Leclercq
  • Frédéric Clarençon
Original Article

Abstract

Human immunodeficiency virus (HIV)-associated ectatic cerebral vasculitis (HIV-AECV) is a rare form of vasculitis with diffuse fusiform aneurysms. Its pathophysiology remains poorly understood. Although extensively described in children, it is still incompletely studied in adults. Our objective was to present five adult cases with emphasis on imaging findings and long-term evolution. From 2006 to 2014, we included 5 HIV-infected patients presenting with fusiform cerebral aneurysms. Vessels abnormalities were assessed with brain computed tomography (CT) angiography, magnetic resonance angiography (MRA) and/or digital subtraction angiography (DSA). All patients had MR assessment of the brain. Clinical and biological data were analyzed. Fusiform aneurysms of carotid terminations extending to middle and anterior cerebral arteries were bilateral in three patients and unilateral in one. More distal fusiform aneurysms were observed in four patients and saccular aneurysms in two patients, two patients suffered from ischemic lesions while none experienced hemorrhage. Unlike recent reviews, our study underlines the low hemorrhagic potential of HIV-AECV and long-term follow-up suggests a monophasic evolution under antiretroviral medication.

Keywords

Human immunodeficiency virus Acquired immunodeficiency syndrome Cerebral vasculitis Fusiform aneurysm Circle of Willis 

Abbreviations

CT

Computed tomography

CTA

CT angiography

DSA

Digital subtraction angiography

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

HIV-AECV

HIV-associated ectatic cerebral vasculitis

ICA

Internal carotid artery

MRA

Magnetic resonance angiography

MRI

Magnetic resonance imaging

Notes

Acknowledgements

The authors would like to thank Dr David Zucman (Internal Medicine, Hôpital Foch, Suresnes, France) for his assistance in the preparation of this manuscript.

Compliance with ethical guidelines

Conflict of interests

B. Law-ye, R.-Y. Carlier, R. Richard, R. Blanc, C. Jourdan, P. de Truchis, F. Viry, D. Dormont, D. Leclercq and F. Clarençon declare that they have no competing interests.

Ethical standards

Neither approval of the institutional review board nor patient informed consent are required by the ethics committee of the institutions involved in this series for retrospective analysis of patients’ records and imaging data.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Bruno Law-ye
    • 1
    • 2
  • Robert-Yves Carlier
    • 3
    • 4
    • 5
  • Raphaël Richard
    • 3
  • Raphaël Blanc
    • 6
  • Claire Jourdan
    • 7
  • Pierre de Truchis
    • 8
  • Flore Viry
    • 9
  • Didier Dormont
    • 1
    • 2
  • Delphine Leclercq
    • 1
  • Frédéric Clarençon
    • 1
    • 2
  1. 1.Neuroradiology DepartmentAPHP, Hôpital Pitié-SalpêtrièreParisFrance
  2. 2.Pierre et Marie Curie Faculty of MedicineSorbonne UniversitésParisFrance
  3. 3.Radiology DepartmentAPHP, Hôpital Raymond PoincaréGarchesFrance
  4. 4.Paris Ile-de-France Ouest Faculty of MedicineUniversité de VersaillesSaint-Quentin-en-YvelinesFrance
  5. 5.CIC 1429Raymond Hôpital Raymond PoincaréGarchesFrance
  6. 6.Neuroradiology DepartmentAPHP, Fondation Ophtalmologique Adolphe de RotschildParisFrance
  7. 7.Rehabilitation DepartmentAPHP, Hôpital Raymond PoincaréGarchesFrance
  8. 8.Infectious Diseases DepartmentAPHP, Hôpital Raymond PoincaréGarchesFrance
  9. 9.Radiology DepartmentAPHP, Hôpital Saint-AntoineParisFrance

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