CLINICAL AND BIOCHEMICAL-ANALYSIS IN INFECTION-ASSOCIATED STROKE

Background and Purpose Currently, recent infection (primarily bacteria l infection) is discussed as a risk factor for cerebrovascular ischemi a. The aim of this study was to investigate whether the association of ischemic stroke with recent infection is restricted to stroke subtype s and whether recent infection influences the severity of the postisch emic deficit; we also aimed to define biochemical pathways linking inf ection and ischemic stroke. Methods Analyzing the data of a prospectiv e case-control study, we classified the etiology of cerebrovascular is chemia on the basis of clinical, neuroradiological, sonographical, car diological, and biochemical data in 159 patients without and in 38 pat ients with infection within 1 week before ischemia. We assessed the se verity of neurological deficits using the Scandinavian Stroke Scale.Re sults In patients with recent infection compared with patients without infection, the neurological deficit on admission was more severe (med ian of scores, 41 versus 30.5; P<.005), cortical infarcts in the middl e cerebral artery territory were more frequent (60% versus 26%; P<.001 ), the prevalence of extracranial artery stenoses was lower (9% versus 26%; P<.05), and definite or presumed cardioembolic stroke was more f requent (34% versus 19%; P<.05), as was stroke from cervical artery di ssection (8% versus 1.3%; P=.05). Serum levels of C-reactive protein w ere higher in patients with (20.7+/-26.8 mg/L) than in those without i nfection (9.2+/-23.7 mg/L; P<.01). Conclusions Recent infection may be associated with a more severe postischemic deficit and with an increa sed risk of stroke from cardioembolic origin and from cervical arteria l dissection.