Central nervous system findings as seen in patients with Human Immunodeficiency Virus infection, undergoing computerised tomography examination at Kenyatta National Hospital

Abstract

In this prospective study over a period of six months, in patients with AIDS and clinical CNS symptoms at KNH between July IS! ] 998- December 31 1998, a total of 107 . patients with CNS symptoms had CT scan examination, 4 of these patients had CT myelograms and the rest 103 had CT scan of the head examinations. The patients were grouped into six clinical groups depending on their clinical presentations. Various radiological reports were given. Of the 107 patients, normal CT scan reports were given on ] 9 patients (17.8%), while the rest 88 patients (82.2%) had various abnormal radiological reports. The sensitivity of CT on picking radiological abnormality in the study was (82.2%) while normal reports were given in (17.8%), this could be because the patient had normal scan, the cause of the neurological CNS abnormality could have been metabolic or failure of CT to pick very early and small cortical white matter lesions. The commonest clinical group scanned was group 5 which presented with focal neurological signs and any other symptoms, it had a frequency of 43 patients (40.2%). This was followed by group 2 presenting with diffuse cerebral dysfunction; personality change; altered affect; poor memory; decreased concentration; confusion; ataxia alone or in combination this group had a frequency of]9 (17.8%), group 3 had 15 patients (14%) and it presented with headache, fever, photophobia and neck stiffness. Group 4 was the 4th commonest and it presented with fits 14 patients were registered in this group accounting for (13.] %), group 6 with 11 patients (10.3%) presented with depressed level of consciousness, fever plus confusion without meningism; fever plus headache without meningism lastly group 1 had the least number of patients with 5 (4.7%) and the clinical presentation was headache alone. The commonest radiological finding was abscess in 32 patients (29.9%) followed by atrophy in 30 patients (28%), normal in 19 patients (17.8%), infarcts 15 (]4%) encephalitis 10 (9.3%) hydrocephalus 5 (4.7%). Other radiological abnormalities which included myelopathy, Progressive Multifocal Leucoencephalopathy, bleed, sinusitis and mastoiditis were reported in 6 patients 5.6%). After the analysis of the clinical presentation all the 107 patients had good reason for CT examination since positive radiological findings were found in all the six groups of clinical presentation and the pick up rate was high 82.2%.