Chutinet Aurauma, Charnnarong Chutibhorn, Suwanwela Nijasri C
Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Cerebrovasc Dis Extra. 2025;15(1):118-129. doi: 10.1159/000544986. Epub 2025 Mar 11.
Stroke related to infections represents a less common but significant cause, particularly in low- and middle-income countries. This review examines the pathophysiology of stroke from infections, involving both direct and indirect mechanisms.
Bacterial infections such as tuberculous meningitis and infective endocarditis can directly cause strokes through local inflammation, arteritis, and septic embolism. Viral infections like Varicella zoster virus and HIV increase stroke risk through chronic immune activation, vasculopathy, and endothelial dysfunction. Parasitic infections, particularly malaria and neurocysticercosis, can cause strokes via vascular occlusion and inflammatory responses. Fungal infections like aspergillosis and mucormycosis can lead to strokes through vasculitis and direct invasion of the CNS.
Understanding the mechanisms by which various infectious agents contribute to stroke pathogenesis is essential for developing targeted therapeutic strategies and improving patient outcomes. Further research is needed to establish effective prevention and treatment for infection-related strokes, especially in low- and middle-income countries.
与感染相关的中风是一种不太常见但很重要的病因，在低收入和中等收入国家尤为如此。本综述探讨了感染引发中风的病理生理学，涉及直接和间接机制。
诸如结核性脑膜炎和感染性心内膜炎等细菌感染可通过局部炎症、动脉炎和脓毒性栓塞直接导致中风。水痘带状疱疹病毒和艾滋病毒等病毒感染通过慢性免疫激活、血管病变和内皮功能障碍增加中风风险。寄生虫感染，尤其是疟疾和神经囊尾蚴病，可通过血管闭塞和炎症反应导致中风。曲霉病和毛霉病等真菌感染可通过血管炎和对中枢神经系统的直接侵袭导致中风。
了解各种感染因子导致中风发病的机制对于制定有针对性的治疗策略和改善患者预后至关重要。需要进一步研究以建立针对感染相关性中风的有效预防和治疗方法，尤其是在低收入和中等收入国家。
