Intracranial space-occupying lesions in acquired immune deficiency syndrome patients.

The recent description of the acquired immune deficiency syndrome (AIDS) followed the observation of an increased incidence of unusual neoplasms and opportunistic infections in previously healthy homosexual men, intravenous drug abusers, Haitians, hemophiliacs, and certain infants. Active research efforts on this group of patients established a defect in cellular immunity. Six patients with AIDS who underwent neurosurgical procedures for intracranial space-occupying lesions are presented. Two of the patients had toxoplasmosis brain abscesses, one had primary central nervous system lymphoma, one had cytomegalovirus encephalitis, one had progressive multifocal leukoencephalopathy, and one patient remained undiagnosed despite pathological examination of the brain tissue specimen. We recommend brain biopsy in AIDS patients with space-occupying lesions because the regimen for the various conditions differs. Although the central nervous system diseases found in AIDS patients are associated with a high mortality rate, four of the six patients responded favorably to specific treatment.