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December 1990

Reduced Cerebral Blood Flow in Early Stages of Human Immunodeficiency Virus Infection

Author Affiliations

From the Departments of Neurology (Drs Schielke, Pfister, Trenkwalder, and Einhäupl) and Radiology, Division of Nuclear Medicine (Drs Tatsch, Leinsinger, and Kirsch), Klinikum Grosshadern; and the Department of Internal Medicine, Medizinische Poliklinik (Dr Matuschke), University of Munich (Federal Republic of Germany).

Arch Neurol. 1990;47(12):1342-1345. doi:10.1001/archneur.1990.00530120088015

• In order to determine if brain perfusion abnormalities, which are known in patients with acquired immunodeficiency syndrome dementia, occur in early stages of human immunodeficiency virus infection, technetium 99m hexamethyl-propyleneamine oxime-single-photon emission computed tomography studies were performed in 20 patients infected with human immunodeficiency virus who belonged to Walter Reed stages I through IV. None of these patients demonstrated signs of dementia or severe neurological dysfunction. Pathological patterns of hexamethyl-propyleneamine oxime uptake were seen in 14 patients, seven of whom had normal results during neurological examination. Only four patients had signs of cerebral atrophy on cranial computed tomographic scan. These data suggest that subtle changes in cerebral perfusion seem to arise early in the course of human immunodeficiency virus infection and may indicate human immunodeficiency virus encephalopathy before neurological symptoms or noticeable structural damage occurs.