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Intrathecal inflammation in young stroke.

Marie Süße1, Malte Johannes Hannich2, Christine Holbe1

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Inflammatory causes of stroke are rare but crucial to identify. Lumbar puncture in young stroke patients may reveal infectious etiologies, guiding essential treatment.

Keywords:
cerebrospinal fluid analysisinfectioninflammationyoung stroke

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Cerebrospinal Fluid Analysis

Background:

  • Prompt identification of inflammatory stroke causes is vital for targeted treatment.
  • Young stroke patients with cryptogenic ischemic stroke require thorough etiological investigation.

Purpose of the Study:

  • To ascertain the prevalence of inflammatory changes in cerebrospinal fluid (CSF) among young cryptogenic stroke patients.
  • To compare the findings with an older stroke cohort.

Main Methods:

  • Retrospective analysis of 6476 ischemic stroke patients.
  • Inclusion of 122 young (≤55 years) and 156 older stroke patients who underwent lumbar puncture.
  • CSF analysis for inflammatory and infectious markers.

Main Results:

  • Infectious etiology detected in 2.5% of young stroke patients and 1.9% of older patients.
  • Specific infectious causes included vasculitis, neuroborreliosis, viral meningitis sequelae, neurotuberculosis, and septic emboli.
  • Non-specific CSF alterations like increased cell count and intrathecal Ig synthesis were observed in both cohorts.

Conclusions:

  • Infectious etiologies are slightly more prevalent in young stroke patients compared to older ones.
  • Lumbar puncture is recommended for young cryptogenic stroke patients, as brain imaging may not always detect vasculitis.
  • Identifying infectious causes in ischemic stroke is therapeutically significant.