CASE REPORT

Difficulties in establishing a definitive diagnosis of intracerebral hemorrhage in patients with HIV/AIDS

Yuriz Bakhtiar , Muhamad Thohar Arifin, Adrian Pratama

Yuriz Bakhtiar
Department of Neurosurgery, Faculty of Medicine, Universitas Diponegoro-Dr. Kariadi Hospital, Semarang, Indonesia. Email: yuriz_b@fk.undip.ac.id

Muhamad Thohar Arifin
Department of Neurosurgery, Faculty of Medicine, Universitas Diponegoro-Dr. Kariadi Hospital, Semarang, Indonesia

Adrian Pratama
Department of Neurosurgery, Salatiga City Hospital, Indonesia
Online First: April 30, 2021 | Cite this Article
Bakhtiar, Y., Arifin, M., Pratama, A. 2021. Difficulties in establishing a definitive diagnosis of intracerebral hemorrhage in patients with HIV/AIDS. Bali Medical Journal 10(1): 437-441. DOI:10.15562/bmj.v10i1.2249


Introduction: Neurological disorders are observed in about 70% of HIV/AIDS cases, of which intracranial mass lesions characterize 10-20%. In addition, the incidence of intracerebral hemorrhage is frequently associated with several etiologies, including toxoplasmosis and cerebral tuberculosis. This manifestation has been attributed the most common opportunistic infections in developing countries. Therefore, a CT scan of the head is commonly used to provide similar images, and consequently mimic SOL or general brain tumors. Meanwhile, laboratory examinations merely use rapid tests without any serologic assessment for opportunistic infections, which prompts difficulties in the confirmatory diagnostics process.

Method: This paper reports two HIV/AIDS cases with neurological disorders. The first involved two patients with multiple SOLs, while the second was a patient with both SOL and intracerebral hemorrhages. Furthermore, the difficulties in establishing an SOL diagnosis by merely relying on head CT scans are observed in these reports, as only toxoplasmosis and tuberculoma were detected. The dilemma of performing a brain biopsy has also been considered an impeding factor.

Conclusion: intracerebral hemorrhage is prevalent and is also considered another cause of neurological disorders and is still a challenging diagnosis in person with HIV/AIDS.

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