Fig. 2-10-1k

Fig. 2-10-1 A,B,C,D,E,F,G,H,I  Axial and sagittal MR imaging demonstrating symmetrically same sized and slightly high or slightly shortened T₁ signal in bilateral cerebellar dental neuclus, symmetrical high T₁ signal in bilateral basal ganglia.

Fig 2-10-1 J,K,L,M  Axial MR imaging demonstrating hat liked high T₂ signal surrounding bilateral lateral ventricles, strip liked high T₂ signal in bilateral half oval centers.

Diagnosis

AIDS complicated cerebral white matter disease

Discussion

This young patient aged 32 years with long-term history of drug-taking. His clinical manifestations are cerebral multiple whiter matter foci. In population with AIDS, cerebral white matter disease is not rarely seen. But this case is typical with MR imaging demonstrations of multiple cerebral neuclus and cerebral white matter lesions. Among non-AIDS population, multiple foci progressive cerebral white matter disease is rarely seen with the first case report in the year of 1958 by Astrom, which is opportunistic in immunocompromised person, immune inhibition therapy receiver and immunodeficient person. Its highest occurrence is in the age group between 40 years to 60 years. People aged less than 30 years has rare occurrence and the male patients are more than female patients. The pathogen of progressive multiple foci cerebral white mater disease is mainly JC virus and SV-40 virus (Simian Virus) of papovaviridae. Whether the virus carriers can develop into clinically symptomatic patients is related to immunoreaction disturbance of the human body. Pathologically, the cerebral whiter matter has extensive multiple demyelination with scattering and unsymmetrical distribution and the pathological changes are rarely seen in cerebellum, brain stem and spinal cord. For this case, there are demyelination foci in cerebellum and cerebrum, which is mainly due to the immunodeficiency of the patient and the accompanying JC virus infection.