The Pattern Of Central Nervous System Findings Seen In Patients With Human Immunodeficiency Virus Infection Undergoing Magnetic Resonance Imaging Examination As Seen In Nairobi.

Abstract

This is a Descriptive cross sectional study on MRI findings in patients with HIV and clinical CNS symptoms in Nairobi during the period 1st may 2007 to 31st September 200S. A total of 123 patients had CNS MRl scan examinations. Of these 119(96.7%) patients had brain MRI scans and 5(3.3%) patients had spine MRI scans. Of the 123 patients normal reports were given in 18(14.8%) patients while 105(85.2%) patients had various abnormal imaging reports. Thus the sensitivity of MRI in detecting imaging abnormality in the study was 85.2% Based on the clinical presentation on the request forms the patients were grouped into six clinical groups. The commonest clinical presentation was observed in Group III that presented with focal neurological signs with a frequency of 43(32.5%) patients.The second clinical presentation was in Group VI with diffuse cerebral dysfunction, confusion, coma, aphasia, semi coma and dysathria that had a frequency of 29(23.6%) patients. Group IV patients presented with cerebellar signs with a frequency of 23(18.7%) patients. Group II patients presented with convulsions with a frequency of 15(12.2%) patients. Group V and Group I had the least frequency of 8(6.5%) patients each. Group I patients presented with headache alone and group V presented with visual disturbances. The commonest imaging finding was atrophy in 28 patients (22.7%),followed by normal in 18 patients(14.6%), abscess 17 patients(13.8%), PML 13 patients (10.6%), toxoplasmosis 10 patients (8.1%), TBMl Tuberculoma 7 patients (5.7%), cerebral infarcts 6 patients (4.9%), Tuberculosis of the spine 5 patients (4.1%), HIVE 4 patients (3.2%) , Meningitis 4 patients (3.2%), encephalitis with hydrocephalus 3 patients (2.4%) turnouts 3 patients (2.4%) ,haemorrhage 2 patients (1.6%). Other findings reported were Cryptococcal meningitis, sinus thrombosis and encephalitis alone. Each of these had 1patient (0.8%). After analysis of the clinical and imaging findings, all the 123 patients had a good reason for MRI examination since positive imaging findings were reported in all the six groups of Clinical presentations and the pick rate was high 85.2%.