Diagnostic Value and Safety of Stereotactic Biopsy in Acquired Immune Deficiency Syndrome Patients with Intracranial Lesions: Systematic Review and Meta-Analysis

Zhang, Jibo; Liu, Xuemeng; Fu, Kai; Xu, Congcong; Gong, Rui; Liu, Li; Guo, Tao; Zhou, Hui; Zhao, Xinyu; Chen, Jincao

doi:10.1016/j.wneu.2016.11.151

Cited by 16 publications

(10 citation statements)

References 37 publications

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“…A recent meta-analysis (19 studies, 820 PLWHA underwent stereotactic brain biopsy) found a diagnostic success rate of 92%. 138 This rate for brain biopsy compares favorably to other patient populations. Another meta-analysis (26 studies, 1209 PLWHA underwent stereotactic biopsy-24 studies, open brain biopsy-1 study, or both techniques-7 studies) showed a diagnostic success rate significantly higher in the post-cART than the pre-cART era (97.5% versus 91.9%, respectively, P ¼ .047).…”

Section: Brain Biopsymentioning

confidence: 91%

Section: Diagnosismentioning

confidence: 98%

“…138 Management change was 60% and clinical improvement was 34%, presumably as a direct result for new information obtained from stereotactic brain biopsy. 138…”

Section: Diagnosismentioning

confidence: 98%

“…139 The rates of morbidity and mortality of PLWHA who underwent stereotactic brain biopsy are 5% and 0.7%, respectively. 138 Management change was 60% and clinical improvement was 34%, presumably as a direct result for new information obtained from stereotactic brain biopsy. 138 The 3 most common diagnoses obtained from stereotactic or open brain biopsies of focal brain lesion in PLWHA are PCNSL (15%-28%), PML (21)(22), and cerebral toxoplasmosis (19%-20%).…”

Section: Brain Biopsymentioning

confidence: 98%

“…The 3 most common diagnoses obtained from stereotactic or open brain biopsies of focal brain lesion in PLWHA are PCNSL (15%-28%), PML (21-22), and cerebral toxoplasmosis (19%-20%). 138,139…”

Section: Diagnosismentioning

confidence: 99%

See 4 more Smart Citations

HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease

Vidal

2019

J Int Assoc Provid AIDS Care

133

152

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Cerebral toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characteristics are focal subacute neurological deficits and ring-enhancing brain lesions in the basal ganglia, but the spectrum of clinical and neuroradiological manifestations is broad. Early initiation of antitoxoplasma therapy is an important feature of the diagnostic approach of expansive brain lesions in PLWHA. Pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) seem to present similar efficacy, but TMP-SMX shows potential practical advantages. The immune reconstitution inflammatory syndrome is uncommon in cerebral toxoplasmosis, and we now have more effective, safe, and friendly combined antiretroviral therapy (cART) options. As a consequence of these 2 variables, the initiation of cART can be performed within 2 weeks after initiation of antitoxoplasma therapy. Herein, we will review historical and current concepts of epidemiology, diagnosis, and treatment of HIV-related cerebral toxoplasmosis.

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Section: Brain Biopsymentioning

confidence: 91%

Section: Diagnosismentioning

confidence: 98%

“…138 Management change was 60% and clinical improvement was 34%, presumably as a direct result for new information obtained from stereotactic brain biopsy. 138…”

Section: Diagnosismentioning

confidence: 98%