Shen Guiquan, Shen Xudong, Pu Wei, Zhang Gang, Lerner Alexander, Gao Bo
Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.
Department of Radiology, Enshi Central Hospital, Enshi 445000, China.
Quant Imaging Med Surg. 2018 Nov;8(10):1039-1051. doi: 10.21037/qims.2018.11.08.
Cerebrovascular complications may occur in infectious diseases in the setting of infective endocarditis, central nervous system (CNS) infections, systemic bacteremia and sepsis. Cerebrovascular complications of infections include vasculitis, mycotic aneurysms, and thrombophlebitis. Infectious vasculitis of the CNS may cause cerebral hemorrhage, infarction or ischemia. Ruptured aneurysms may endanger the patient's life. Infectious thrombophlebitis may cause intracranial pressure to increase and lead to cerebral hemorrhage. These cerebrovascular complications are associated with a poor prognosis and often cause irreversible neurological deficits. Cerebrovascular events secondary to infection are not easily distinguishable from the more common cerebral infarct and non-infectious vasculitis. In addition, the clinical manifestations of cerebrovascular complications of infections are non-specific and highly variable. Therefore, early imaging, antibiotics, and anticoagulation may be lifesaving the patient's life and prevent disability. The main focus of this article is to review imaging analysis of the cerebrovascular complications of infections and imaging features that help differentiate them from non-infectious vascular diseases.
脑血管并发症可能发生在感染性心内膜炎、中枢神经系统(CNS)感染、全身性菌血症和脓毒症等感染性疾病中。感染的脑血管并发症包括血管炎、真菌性动脉瘤和血栓性静脉炎。中枢神经系统的感染性血管炎可能导致脑出血、梗死或缺血。破裂的动脉瘤可能危及患者生命。感染性血栓性静脉炎可能导致颅内压升高并引发脑出血。这些脑血管并发症预后不良,常导致不可逆的神经功能缺损。继发于感染的脑血管事件不易与更常见的脑梗死和非感染性血管炎区分开来。此外,感染性脑血管并发症的临床表现不具特异性且变化很大。因此,早期影像学检查、使用抗生素和抗凝治疗可能挽救患者生命并预防残疾。本文的主要重点是综述感染性脑血管并发症的影像学分析以及有助于将其与非感染性血管疾病区分开来的影像学特征。