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Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body
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Lacunar Stroke in Cryptococcal Meningitis: Clinical and Radiographic Features.

Daniel Vela-Duarte1, Eric Nyberg2, Stefan Sillau1

  • 1Department of Neurology, University of Colorado Denver.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|January 19, 2019
PubMed
Summary
This summary is machine-generated.

Cryptococcal meningitis survivors face high rates of disabling neurologic deficits, including a 26% ischemic stroke complication rate. Anemia and hyponatremia are key predictors of stroke in these patients.

Keywords:
Cryptococcal meningitiscerebral ischemiacryptococcus neoformansrisk factorsstroke, lacunar

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Cryptococcal meningitis has high mortality and causes significant neurologic sequelae in survivors.
  • The pathogenesis of neurologic deficits and stroke features in cryptococcal meningitis remain poorly understood.

Purpose of the Study:

  • To describe the clinical and radiographic features of stroke in patients with cryptococcal meningitis.
  • To identify predictors of stroke in this patient population.

Main Methods:

  • Retrospective cohort study of 42 patients with cryptococcal meningitis (2000-2018).
  • Analysis of neuroimaging studies for 32 patients.
  • Bivariate and regression models used to identify stroke predictors.

Main Results:

  • A 26% ischemic stroke complication rate was observed.
  • Strokes were predominantly acute, lacunar, multiple, bilateral, and involved the basal ganglia.
  • Hyponatremia (RR 5.7) and decreased hemoglobin were significant predictors of ischemic stroke.

Conclusions:

  • Cryptococcal meningitis is associated with a high risk of lacunar stroke, particularly in the basal ganglia.
  • Stroke is common in cryptococcal meningitis and contributes to survivor disability.
  • Malignancy, anemia, and hyponatremia may play a role in cryptococcal meningitis-associated stroke.