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Acute bacterial meningitis and stroke.

Jason L Siegel1

  • 1Mayo Clinic Florida, 4500 San Pablo Rd, 32224 Jacksonville, United States. siegel.jason@mayo.edu.

Neurologia I Neurochirurgia Polska
|August 24, 2019
PubMed
Summary

Acute bacterial meningitis can cause ischemic stroke due to neuroinflammation. While corticosteroids show some benefit, new targeted therapies are needed to prevent neurological damage and improve outcomes.

Keywords:
bacterial meningitisneuroinflammationpneumococcal meningitisstroke

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Neurology

Background:

  • Acute bacterial meningitis is a prevalent disease, particularly in developing nations.
  • Neurological adverse effects, including acute ischemic stroke, remain significant despite medical advances.
  • Ischemic stroke is a serious comorbidity indicating disease severity and poor prognosis in meningitis patients.

Purpose of the Study:

  • To review the clinical relationship between meningitis and stroke.
  • To discuss the neuroinflammatory pathways linking these conditions.
  • To explore potential therapeutic targets for mitigating stroke risk in meningitis.

Main Methods:

  • Literature review focusing on the pathophysiology of meningitis-induced stroke.
  • Analysis of neuroinflammatory mechanisms, including cytokine release and coagulation cascade activation.
  • Examination of clinical data and research findings on therapeutic interventions.

Main Results:

  • The inflammatory response to bacterial pathogens damages the blood-brain barrier and triggers cerebral vasculopathy and hypercoagulation.
  • Cytokine release contributes to neuronal death and exacerbates the inflammatory cascade.
  • Early corticosteroid administration in bacterial meningitis may reduce mortality but carries risks of delayed cerebral infarction.

Conclusions:

  • Neuroinflammation plays a critical role in the pathogenesis of ischemic stroke secondary to bacterial meningitis.
  • Pharmacological interventions like corticosteroids have mixed results, necessitating further research.
  • Emerging therapeutic strategies targeting specific inflammatory markers and genetic markers show promise for future individualized treatments.