Queston #6469Note

Patients with poorly controlled HIV/AIDS are at risk for a variety of neurological diseases including primary CNS lymphoma, PML, cerebral toxoplasmosis, and opportunistic cerebral fungal infections. The HIV virus can also cause damage to brain parenchymal cells over time and lead to HIV-associated dementia. Risk factors for HIV-related dementia include high viral loads, low CD4 counts, chronic infection, and older age at the time of infection. On MRI, HIV-related dementia will present with cerebral atrophy and T2 changes in the periventricular and deep white matter and no signs of edema or contrast enhancement. This is what is seen in the included imaging. All other possible answers have much more dramatic changes on imaging. PML can also present with T2 changes in white matter but its findings are much more pronounced than the image provided.