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Stroke transcranial Doppler in children with human immunodeficiency virus

Dlamini, N; Pohl, K; Eley, B; Van Toorn, R; Kilborn, T; Padayachee, S; Pontigon, A-M; ... Wilmshurst, J; + view all (2020) Stroke transcranial Doppler in children with human immunodeficiency virus. Developmental Medicine & Child Neurology , 62 (6) pp. 735-741. 10.1111/dmcn.14439. Green open access

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Abstract

Aims: To describe stroke syndromes and transcranial Doppler (TCD) findings in children with human immunodeficiency virus (HIV) and examine the associations between TCD and clinical and laboratory data. / Method: We enrolled 42 children (24 males, 18 females) with HIV (median age=7y 6mo; 2y 7mo–15y 6mo), with and without stroke who underwent a TCD examination of the anterior and posterior circulations to derive time‐averaged maximum mean velocity (TAMMV) measurements for comparison with previous studies. Clinical and laboratory variables were extracted from the medical records. / Results: Of the 42 children with HIV, five had right‐sided hemiparesis, three had chronic lung disease, two occurred post‐varicella infection, one after herpetic oral ulceration, and one had a poorly functioning left ventricle. Neuroimaging showed middle cerebral artery (MCA) TAMMV greater than 200cm/s, moyamoya‐like arteriopathy, left basal ganglia infarction with ipsilateral stenosis, hygroma consistent with venous thrombosis, and a hyperdense left MCA. Eight neurologically asymptomatic children had atypical TCD. The CD4 cell count was non‐significantly lower in 6 out of 30 children with atypical TCD (median=21.5; interquartile range=16.1–26.5) compared with the remainder (median=29; interquartile range=21.3–35.0; p=0.09). / Interpretation: A variety of stroke syndromes occur in children with HIV. TCD suggests atypical intracranial vessels and/or haemodynamics in some children with HIV infection, consistent with vasculopathy, possibly related directly to immunodeficiency and/or infection.

Type: Article
Title: Stroke transcranial Doppler in children with human immunodeficiency virus
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dmcn.14439
Publisher version: https://doi.org/10.1111/dmcn.14439
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10095220
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