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A definitive diagnosis was obtained in 24 patients(92%),of whom 12(46%)had primary brain lymphoma,six(23%)had progressive multifocal leukoencephalopathy,and four(15%)had Toxoplasma encephalitis.Two thirds of contrast-enhancing lesions on computed tomography were lymphoma and three fourths of contrast-negative lesions were leukoencephalopathy.Three patients had biopsy-related cerebral hemorrhages(morbidity,11.5%).Median follow-up and survival for the entire group were 24 weeks(range 6 to 135 weeks).Twenty patients(77%)received specific therapy and 13(50%)responded to treatment.Of 11 patients with lymphoma undergoing irradiation treatment (whole-brain radiotherapy in seven and y-knife treatment in four),nine (82%)had clinical and radiologic response,with a median survival of 34 weeks(range,13 to 57 weeks).Sterotactic brain biopsy has high diagnostic efficacy and clinical benefit in carefully selected human immunodeficiency virus-infected patients.The procedure should be performed essentially in patients with contrast-enhancing lesions on computed tomography who have a high frequency of treatable cerebral diseases. |
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acquired immunodeficiency syndrome
brain biopsy
brain biopsy,complications of
brain biopsy,stereotaxic
CAT scan
CAT scan,abnormal
CAT scan,contrast enhanced
human immunodeficiency virus type 1
Karnofsky performance scale
life expectancy
lymphoma
lymphoma involving CNS
prognosis
progressive multifocal leucoencephalopathy
toxoplasmosis,CNS
treatment of neurologic disorder
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