HIV is known to increase the risk of both ischemic and hemorrhagic strokes. There are many postulated mechanisms for this elevated risk including an HIV-induced vasculopathy and/or coagulopathy, opportunistic infections, and cardioembolic etiologies, among others. Regarding vasculopathy, prior reports have described the various changes to the arterial vasculature that can occur in the setting of HIV, yet the appropriate workup and management of this condition remains poorly defined. Here we describe two cases of patients with HIV presenting with large vessel intracranial occlusions in the setting of ectatic extracranial vasculature accompanied by intraluminal thrombus formation. One patient underwent thrombectomy, while the other improved after receiving IV-tPA. Inferring on these cases and the existing literature, a standardized workup and treatment algorithm is proposed, emphasizing the key management decisions that should be considered on a case-by-case basis.

众所周知，艾滋病毒会增加缺血性和出血性中风的风险。这种升高的风险有许多假设的机制，包括 HIV 引起的血管病和/或凝血病、机会性感染和心源性栓塞病因等。关于血管病变，先前的报告已经描述了在 HIV 环境中可能发生的动脉血管系统的各种变化，但对这种情况的适当检查和管理仍然不明确。在这里，我们描述了两个 HIV 患者在颅外血管扩张伴有腔内血栓形成的情况下出现大血管颅内闭塞的病例。一名患者接受了血栓切除术，而另一名患者在接受 IV-tPA 后病情有所好转。推断这些案例和现有文献，