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[中风的炎症性病因——诊断与治疗]

[Inflammatory causes of stroke-Diagnostics and treatment].

作者信息

Schmidt-Pogoda Antje, Straeten Frederike A, Beuker Carolin, Werring Nils, Minnerup Jens

机构信息

Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.

出版信息

Nervenarzt. 2024 Oct;95(10):909-919. doi: 10.1007/s00115-024-01711-8. Epub 2024 Jul 30.

Abstract

Inflammatory causes of stroke are frequent and often pose diagnostic and therapeutic challenges due to the scarcity of randomized trials and the absence of clear guideline recommendations for many scenarios. Following the publication of the recommendations of the European Stroke Organization on primary angiitis of the central nervous system (PACNS) last year, the German Neurological Society (DGN) has issued very clear guidelines this year on the diagnostics and treatment of PACNS and updated the recommendations for systemic vasculitides; however, stroke often occurs not only as a result of primary vascular inflammation but also as a complication of another organ infection. Approximately 5% of all patients with sepsis, ca. 20% of patients with bacterial meningitis and up to 40% of patients with bacterial endocarditis suffer from a stroke as a complication. This article summarizes the key characteristics of these inflammatory causes of stroke and particularly focuses on the current recommendations for diagnostic and therapeutic management.

摘要

炎症性中风病因常见,由于随机试验稀缺,且在许多情况下缺乏明确的指南建议,常给诊断和治疗带来挑战。继欧洲中风组织去年发布关于中枢神经系统原发性血管炎(PACNS)的建议后,德国神经病学学会(DGN)今年发布了关于PACNS诊断和治疗的非常明确的指南,并更新了系统性血管炎的建议;然而,中风不仅常由原发性血管炎症引起,也可作为其他器官感染的并发症出现。所有脓毒症患者中约5%、细菌性脑膜炎患者中约20%以及细菌性心内膜炎患者中高达40%会并发中风。本文总结了这些炎症性中风病因的关键特征,并特别关注当前诊断和治疗管理的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50ef/11427622/9a6c823190a1/115_2024_1711_Fig1_HTML.jpg

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