Journal Mobile Options
Table of Contents
Vol. 15, No. 3, 2003
Issue release date: March 2003
Cerebrovasc Dis 2003;15:199–205

Ischaemic Cerebrovascular Events in HIV Infection

A Cohort Study

Evers S. · Nabavi D. · Rahmann A. · Heese C. · Reichelt D. · Husstedt I.-W.
Departments of aNeurology, bInternal Medicine B, and cMedicine D, University of Münster, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Several case reports and series described ischaemic cerebrovascular events in HIV infection. However, the exact prevalence and the clinical features of these events are unknown. We performed a cohort study on 772 consecutive HIV infected patients and evaluated the rate of transient ischaemic attacks (TIA) and of completed stroke. A total prevalence of 1.9% for TIA (0.8%) and stroke (1.2%) was calculated resulting in an annual incidence rate of 216 per 100,000. The prevalence was highest in the later stages of the infection. Stroke patients had a poorer immunological state than the TIA and the cohort patients. Probable (n = 3) and possible (n = 2) vasculitis and cardiogenic embolism (n = 2) could be detected as aetiology, the remaining patients had a cryptogenic event. Our data suggest that ischaemic cerebrovascular events are more common in HIV infected patients than in the general population and that a part of these events might be caused by HIV associated vasculitis or vasculopathy.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Price RW: Neurological complications of HIV infection. Lancet 1996;348:445–452.
  2. Qureshi AI, Janssen RS, Karon JM, Weissman JP, Akbar MS, Safdar K, Frankel MR: Human Immunodeficiency Virus infection and stroke in young patients. Arch Neurol 1997;54:1150–1153.
  3. Keeling DM, Birley H, Machin SJ: Multiple transient ischemic attacks and a mild thrombotic stroke in a HIV-positive patient with anticardiolipine antibodies. Blood Coag Fibrinol 1990;1:333–335.
  4. Casado-Naranjo I, Toledo-Santos JA, Antolin-Rodriguez MA: Ischemic stroke as the sole manifestation of HIV infection. Stroke 1992;23:117–118.
  5. Atalaia A, Ferro J, Antunes F: Stroke in an HIV-infected patient. J Neurol 1992;239:356–357.
  6. Kieburtz KD, Eskin TA, Ketonen L, Tuite JT: Opportunistic cerebral vasculopathy and stroke in patients with the acquired immunodeficiency syndrome. Arch Neurol 1993;50:430–432.
  7. Thirumalai S, Kirshner HS: Anticardiolipin antibody and stroke on an HIV-positive patient. AIDS 1994;8:1019–120.
  8. Baily GG, Mandal BK: Recurrent transient neurological deficits in advanced HIV infection. AIDS 1995;9:709–712.
  9. Pinto AN: AIDS and cerebrovascular disease. Stroke 1996;27:538–543.
  10. Zunker P, Nabavi DG, Allardt A, Husstedt IW, Schuierer G. HIV-associated stroke: report of two unusual cases. Stroke 1996;27:1694–1696.
  11. Berkefeld J, Enzensberger W, Lanfermann H: MRI in human immunodeficiency virus-associated cerebral vasculitis. Neuroradiology 2000;42:526–528.
  12. Hoffmann M, Berger JR, Nath A, Rayens M. Cerebrovascular disease in young, HIV-infected, black Africans in the KwaZulu Natal province of South Africa. J Neurovirol 2000;6:229–236.
  13. Menge T, Neumann-Haefelin T, von Giesen HJ, Arendt G: Progressive stroke in an HIV-1-positive patient under protease inhibitors. Eur Neurol 2000;44:252–254.
  14. Park YD, Belman AL, Kim TS, Kure K, Llena JF, Lantos G, Bernstein L, Dickson DW: Stroke in pediatric acquired immunodeficiency syndrome. Ann Neurol 1990;28:303–311.
  15. Philippet P, Blanche S, Sebag G, Rodesch G, Griscelli C, Tardieu M: Stroke and cerebral infarcts in children infected with human immunodeficiency virus. Arch Pediatr Adolesc Med 1994;148:965–970.
  16. Moriarty DM, Haller JO, Loh JP, Fikrig S: Cerebral infarction in pediatric acquired immunodeficiency syndrome. Pediatr Radiol 1994;24:611–612.
  17. Shah SS Zimmermann RA, Rorke LB, Vezina LG: Cerebrovascular complications of HIV in children. Am J Neuroradiol 1996;17:1913–1917.
  18. Visudtibhan A, Visudhiphan P, Chiemchanya S: Stroke and seizures as the presenting signs of pediatric HIV infection. Pediatr Neurol 1999;20:53–56.
  19. Legido A, Lischner HW, Chadarevian JP, Katsetos CD: Stroke in pediatric HIV infection. Pediatr Neurol 1999;21:588.
  20. Engstrom JW, Lowenstein DH, Bredesden DE: Cerebral infarctions and transient neurologic deficits associated with acquired immunodeficiency syndrome. Am J Med 1989;86:528–532.
  21. Kristensen B, Malm J, Carlberg B, Stegmayr B, Backman C, Fagerlund M, Olsson T: Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern Sweden. Stroke 1997;28:1702–1709.
  22. Eisenblätter D, Claßen E, Schädlich H, Heinemann L: Häufigkeit und Prognose von Schlaganfallerkrankungen in der Bevölkerung Ostdeutschlands. Ergebnisse von Schlaganfallregistern in den Jahren 1985–1988. Nervenarzt 1994;65:95–100.
  23. Berger K, Schulte H, Stögbauer F, Assmann G: Incidence and risk factors for stroke in an occupational cohort: the PROCAM study. Stroke 1998;29:1562–1566.
  24. Blecic S, Bogousslavsky J: Stroke in young adults; in Barnett HJM, Mohr JP, Stein BM, Yatsu FM (eds): Stroke. Pathophysiology, Diagnosis, and Management. New York, Churchill-Livingstone, 1998, pp 1001–1012.
  25. Berger JR, Harris JO, Gregorius J, Novemberg M: Cerebrovascular disease in AIDS: a case control study. AIDS 1990;4:239–244.
  26. Mizusawa H, Hirano A, Siena JF, Shuitaku M: Cerebrovascular lesions in aquired immunodeficiency syndrome (AIDS). Acta Neuropathol 1988;76:451–457.
  27. Connor MD, Lammie GA, Bell JE, Warlow CP, Simmonds P, Brettle RD: Cerebral infarction in adult AIDS patients – observations from the Edinburgh HIV autopsy cohort. Stroke 2000;31:2117–2126.

    External Resources

  28. Headache Classification Committee of the International Headache Society: Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988;8(suppl 7):1–92.
  29. Centers for Disease Control and Prevention: 1993 revised classification system for HIV-infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 1992;41:1–19.
  30. Terada LS, Gu Y, Flores SC: AIDS vasculopathy. Am J Med Sci 2000 320:379–387.
  31. Chetty R: Vasculitides associated with HIV infection. J Clin Pathol 2001 54:275–278.
  32. Brilla R, Nabavi DG, Schulte-Altedorneburg G, Kemeny V, Reichelt D, Evers S, Schiemann U, Husstedt IW: Cerebral vasculopathy in HIV-infection revealed by transcranial Doppler – a pilot-study. Stroke 1999;30:811–813.
  33. Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, Glahn J, Brandt T, Hacke W, Diener HC: Risk factors, outcome, and treatment in subtypes of ischemic stroke: the german stroke data bank. Stroke 2001;32:2559–2566.

    External Resources

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50