Life in the Fast Lane Medical Blog » JFICM http://lifeinthefastlane.com Emergency Medicine education blog Fri, 25 May 2012 00:00:01 +0000 en hourly 1 http://wordpress.org/?v=3.3.2 HIV and an abnormal CT Headhttp://lifeinthefastlane.com/2009/11/icu-case-1-a-cns-mass-lesion-in-and-hiv-positive-male/ http://lifeinthefastlane.com/2009/11/icu-case-1-a-cns-mass-lesion-in-and-hiv-positive-male/#comments Mon, 23 Nov 2009 17:38:15 +0000 Paul Young http://lifeinthefastlane.com/?p=8222

Life in the Fast Lane Medical Blog HIV and an abnormal CT Head

Consider a 45 year-old HIV positive male with right hemiparesis and fluctuating conscious state. His CT head is shown below.

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aka Neurological Mind-boggler 001
Consider a 45 year-old HIV positive male with right hemiparesis and fluctuating conscious state. His CT head is shown below.

CT #1

CT #2

Questions

Q1.Describe the CT Head findings.

This scan shows a left frontoparietal hypodense lesion with surrounding oedema and mass effect which shows enhancement with contrast.

Q2. Outline the differential diagnosis.

In HIV CNS lesions can be divided into those which exhibit mass effect and those that do not.

CNS lesions with mass effect include:

  • toxoplasma encephalitis
  • primary CNS lymphoma
  • tuberculoma (more common in the developing world)
  • other lesions are less common but include brain abscesses secondary to Staphylococcus, Streptococcus, Salmonella, Aspergillus, Nocardia, Listeria & Cryptococcus

NB: toxoplasmosis and primary CNS lymphoma are the most common

CNS lesions without mass effect are commonly due to:

  • progressive multifocal encephalopathy, or
  • HIV-associated encephalitis

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Life in the Fast Lane Medical Blog ICU Mind Maps

New to Life in the Fast Lane is a collection of 'Mind Maps' encompassing the entire curriculum for the Fellowship examination of the Joint Faculty of Intensive Care Medicine.

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]]> Life in the Fast Lane Medical Blog ICU Mind Maps

New to Life in the Fast Lane is a collection of ‘Mind Maps’ encompassing the entire curriculum for the Fellowship examination of the Joint Faculty of Intensive Care Medicine.

The ICU Mind Maps were created by Dr Paul Young in 2007 and 2008 and have since been used by a number of successful candidates preparing for the JFICM exam. They contain information extracted, synthesized and summarized from a variety of sources recommended by the Joint Faculty.

Peripheral arterial diseaseThe Mind Maps are free to use and redistribute and can be found here, or by clicking on Mind Maps, after moving the mouse pointer over ‘Exams’ and then ‘JFICM Fellowship’ on the website header (where you’ll find lots of other stuff awaiting discovery…) as shown below.

LITFL_screenshot2

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