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文献报道获得性免疫缺陷综合征(AIDS)患者中1％有脑血管病的临床表现,尸检发现10～30％有脑梗塞,但未见有AIDS患者伴机会性中枢神经系统疾病引起血管病导致卒中的病理报道。现作者报告3例。 例1 女,26岁,患AIDS。恶心、腹泻入院。入院第4天,突发双侧视力丧失为皮质性盲。脑血管造影:两侧大脑后动脉距状支闭塞。入院第3周,血、痰培养出白色念珠菌,虽经二性霉素B治疗,但病情恶化,住院1月死亡。脑尸检示:播散性念珠菌类霉菌丝微脓肿,侵入血管,致两侧大脑后动脉分支血栓形成。例2,男。62岁,感染人类免疫缺陷病毒3年。意识模糊,左侧肢体力弱入院。头颅CT:右顶叶低密度损害。5天后新发现言语障碍和右侧轻偏瘫,住院后3周死亡。尸检:脑组织大片梗死,以右半球为主,血管壁及内膜有巨大细胞病理改变,含A型核内包涵
Reported in the literature 1% of acquired immunodeficiency syndrome (AIDS) patients with clinical manifestations of cerebrovascular disease, autopsy found 10 to 30% of cerebral infarction, but no AIDS patients with opportunistic central nervous system disease caused by vascular disease Pathological reports of stroke. The authors report 3 cases. Example 1 Female, 26 years old, suffering from AIDS. Nausea, diarrhea admitted to hospital. On admission day 4, sudden bilateral loss of visual acuity was cortical blindness. Cerebral angiography: bilateral posterior cerebral artery occlusion from the branch. The first 3 weeks of admission, blood, sputum culture Candida albicans, although the amphotericin B treatment, but the condition deteriorated, hospitalized January death. Brain autopsy: disseminated Candida fungus filamentous abscess, invade the blood vessels, resulting in both sides of the posterior cerebral artery thrombosis. Example 2, male. 62 years old, infected with human immunodeficiency virus for 3 years. Ambiguous, weak limb left hospital. Head CT: right parietal lobe low density damage. Five days later, new speech impairment and right hemiparesis were found, and 3 weeks after hospitalization died. Autopsy: Cerebral infarction to the vast majority of the right hemisphere, vascular wall and endometrium have a huge cytopathological changes, including A-type nuclear inclusions