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Stroke from Infection
Aurauma Chutinet1,2,3, Chutibhorn Charnnarong4, Nijasri C Suwanwela1,2,3
1Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Background:
Stroke related to infections represents a less common but significant cause, particularly in low- and middle-income countries. This review examines the pathophysiology of stroke from infections, involving both direct and indirect mechanisms.
Summary:
Bacterial infections such as tuberculous meningitis and infective endocarditis can directly cause strokes through local inflammation, arteritis, and septic embolism. Viral infections like Varicella zoster virus and HIV increase stroke risk through chronic immune activation, vasculopathy, and endothelial dysfunction. Parasitic infections, particularly malaria and neurocysticercosis, can cause strokes via vascular occlusion and inflammatory responses. Fungal infections like aspergillosis and mucormycosis can lead to strokes through vasculitis and direct invasion of the CNS.
Key Messages:
Understanding the mechanisms by which various infectious agents contribute to stroke pathogenesis is essential for developing targeted therapeutic strategies and improving patient outcomes. Further research is needed to establish effective prevention and treatment for infection-related strokes, especially in low- and middle-income countries.
Insights
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.
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.
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