A patient with confusion and dizziness

摘要

1. Clinical background:A 45-year-old otherwise healthy man presented with sudden onset of confusion and dizziness. His neurological examination revealed a somnolent man who was oriented to person and place and could follow simple commands. A brain CT scan with contrast (Fig. 1) showed a hypodensity involving the right frontal and anterior parietal lobes with resultant compression of the right lateral ventricle and leftward midline shift. A brain MRI without contrast (Fig. 2) showed a right frontoparietal-enhancing lesion with associated vasogenic edema. Laboratory testing revealed a positive result for human immunodeficiency virus (HIV).