Bilateral pallidal hemorrhage in toxoplasmosis update of acute symmetric lesions of deep nuclei

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,...

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Bibliographic Details
Published in:The Neuroradiology Journal 2015-08, Vol.28 (4), p.413-417
Main Authors: Finelli, Pasquale F, Wrubel, Gregory L
Format: Article
Language:English
Subjects:
Adult
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - drug therapy
Antiprotozoal Agents - therapeutic use
Brain
Diagnosis, Differential
Drug Therapy, Combination
Humans
Magnetic Resonance Imaging
Male
Tomography, X-Ray Computed
Toxoplasmosis, Cerebral - diagnosis
Toxoplasmosis, Cerebral - drug therapy
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Summary: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.
ISSN:1971-4009
2385-1996
DOI:10.1177/1971400915609345