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Updated: May 23, 2025

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Stroke from Infection.

Aurauma Chutinet1,2,3, Chutibhorn Charnnarong4, Nijasri C Suwanwela1,2,3

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Infections, including bacterial, viral, parasitic, and fungal, can cause strokes through various direct and indirect mechanisms. Understanding these pathways is crucial for developing effective treatments and prevention strategies, especially in low-resource settings.

Keywords:
Bacterial meningitisCOVID-19Fungal infectionsHuman immunodeficiency virusInfectionNeurocysticercosisParasitic infectionsPathophysiologyStrokeTuberculous meningitisVaricella zoster virusViral infections

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pathophysiology

Background:

  • Infections are an under-recognized cause of stroke, particularly in low- and middle-income countries.
  • This review explores the direct and indirect pathophysiological mechanisms linking infections to stroke.

Purpose of the Study:

  • To elucidate the diverse mechanisms through which infectious agents contribute to stroke.
  • To highlight the significance of infection-related strokes in global health.

Main Methods:

  • Literature review examining the pathophysiology of stroke related to infections.
  • Analysis of direct and indirect mechanisms of stroke causation by various pathogens.

Main Results:

  • Bacterial infections (e.g., tuberculous meningitis, infective endocarditis) cause stroke via inflammation, arteritis, and embolism.
  • Viral infections (e.g., VZV, HIV) increase stroke risk through immune activation and vasculopathy.
  • Parasitic (e.g., malaria, neurocysticercosis) and fungal infections (e.g., aspergillosis) induce stroke via vascular occlusion, inflammation, and CNS invasion.

Conclusions:

  • Infectious agents trigger stroke through multifaceted mechanisms including inflammation, vasculitis, embolism, and endothelial dysfunction.
  • Targeted therapeutic strategies are needed to address infection-related strokes.
  • Further research is essential for effective prevention and treatment, particularly in resource-limited regions.