Infections and stroke

We will review cerebrovascular complications of infectious diseases of the CNS. The emphasis will be on common infections causing stroke, including pyogenic meningitis, infective endocarditis, tuberculosis, leptospirosis, syphilis, as well as fungal and parasitic diseases. Most of these conditions cause stroke through a mechanism of angiitis, which is an inflammation of the vessel wall induced by the presence of microorganisms within the CNS. A stroke may occur as the primary or sole manifestation of the infectious disease or may present in the setting of a diffuse encephalopathy. Infection-related strokes may be ischemic or hemorrhagic and range in severity from asymptomatic to fatal. Precise knowledge of the spectrum of these conditions is important to direct prompt therapy to reduce the risk of further vascular damage.