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[Infectious diseases as a cause and risk factor for cerebrovascular ischemia]
Insights
Infections, particularly respiratory infections, are increasingly recognized as a significant risk factor for cerebrovascular ischemia, also known as ischemic stroke. Recent infections are linked to a higher risk of stroke, especially in younger individuals.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Cerebrovascular ischemia can stem from various infectious diseases affecting cerebral arteries or the heart.
- Emerging evidence highlights general and respiratory infections as key risk factors for ischemic stroke.
- Previous case reports and series suggest a link between cerebrovascular ischemia and recent infections in pediatric and young adult populations.
Purpose of the Study:
- To review the association between infectious diseases and cerebrovascular ischemia.
- To explore potential pathogenetic mechanisms connecting infections and cerebrovascular ischemia.
Main Methods:
- Review of existing literature, case reports, and case series.
- Analysis of two case-control studies (Helsinki and Heidelberg) investigating infection as a risk factor for ischemic stroke.
Main Results:
- Recent infections, notably febrile, bacterial, and respiratory infections, are identified as significant risk factors for ischemic stroke.
- Infection-associated strokes, particularly in the Heidelberg study, presented with more severe neurological deficits and higher rates of cardioembolism compared to non-infection-associated strokes.
- Studies indicate a particular association in children and younger adults.
Conclusions:
- Infectious diseases represent a critical, often overlooked, cause and risk factor for cerebrovascular ischemia.
- Understanding the pathogenetic links between infection and stroke is crucial for prevention and treatment strategies.
- Further research into the mechanisms is warranted to elucidate the precise relationship.
Abstract:
Cerebrovascular ischemia can be caused by infectious diseases which involve cerebral arteries or the heart, including infectious endocarditis, bacterial and fungal meningitis, neurosyphilis, neuroborreliosis, herpes zoster, the acquired immunodeficiency syndrome, cat scratch disease and other rare infectious diseases. Presently, there is increasing evidence that infection in general and mainly respiratory infection is a risk factor for ischemic stroke. Case reports and smaller case series reported an association of cerebrovascular ischemia and recent infection in children and younger adults. Two case control studies from Helsinki (54 patients under the age of 50) and from Heidelberg (197 patients aged 80 or less) identified recent infection as an important risk factor for ischemic stroke. Febrile, bacterial and respiratory infections were most important in this respect. In the study from Heidelberg, the neurological deficit was more severe and cardioembolism was more frequent in infection-associated stroke than in stroke without preceding infection. This review summarizes the association of infectious diseases and cerebrovascular ischemia and discusses potential pathogenetic mechanisms linking both diseases.