HIV +ve middle aged male, with diorientation
MR findings reveal asymmetric hyperintesities on T2 & FLAIR sequences, involving both cerebral hemispheres (fronto parietal and occipital lobes) and splenium. These lesions extend to the subcortical white matter.
MRI is the preferred diagnostic imaging modality. It is sensitive to white matter lesions and shows hyperintense lesions on T2-weighted (T2W) images in affected regions.
Progressive multifocal leukoencephalopathy
Lesions are found at the gray matter–white matter interface and tend to involve the subcortical white matter.??Progressive multifocal leukoencephalopathy (PML) is a fatal subacute progressive demyelinating disease seen in persons with impaired cell-mediated immune response.??Before the AIDS epidemic, PML was rare and associated with other immunocompromised conditions, such as leukemia, lymphoma.?Prognosis is generally is poor with an inexorable neurologic decline leading to comaand death occurring in the majority of patients with PML.
Dr Alpana Karnik