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Infectious Etiologies of Stroke
Julie G Shulman1,2, Anna M Cervantes-Arslanian1,2,3,4
1Boston University School of Medicine, Boston University, Boston, Massachusetts.
Seminars in Neurology
|September 19, 2019
Summary
Central nervous system infections can cause cerebrovascular disease through various mechanisms. Early diagnosis and treatment are crucial for managing these infections and improving patient prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Central nervous system (CNS) infections are often overlooked as a cause of cerebrovascular disease.
- Infectious agents can lead to stroke through mechanisms like vasculitis, vasospasm, and thrombosis.
Purpose of the Study:
- To review infectious etiologies of cerebrovascular disease.
- To highlight diagnostic and therapeutic considerations for CNS infections causing stroke.
Main Methods:
- Literature review focusing on specific infectious agents and their cerebrovascular complications.
- Analysis of diagnostic approaches including neuroimaging and laboratory studies.
- Discussion of treatment strategies and prognostic factors.
Main Results:
- Varicella zoster virus, syphilis, tuberculosis, aspergillosis, and bacterial meningitis are discussed as key examples.
- Mechanisms include multifocal vasculopathy, focal infiltrative vasculitis, vasospasm, and direct vessel invasion.
- Diagnosis requires high clinical suspicion, detailed examination, and specific investigations.
Conclusions:
- CNS infections represent a significant, underappreciated cause of stroke.
- Prompt and targeted treatment is critical for improving outcomes.
- Effective management necessitates a multidisciplinary approach and thorough diagnostic workup.
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