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Lancet Infect Dis. 2014 Sep;14(9):869-80. doi: 10.1016/S1473-3099(14)70755-8. Epub 2014 May 31.

Infectious causes of stroke.

Author information

  • 1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
  • 2Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • 3Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA.
  • 4Section of Infections of the Nervous System, NINDS, National Institutes of Health, Bethesda, MD, USA.
  • 5Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • 6Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:


Most infectious pathogens have anecdotal evidence to support a link with stroke, but certain pathogens have more robust associations, in which causation is probable. Few dedicated prospective studies of stroke in the setting of infection have been done. The use of head imaging, a clinical standard of diagnostic care, to confirm stroke and stroke type is not universal. Data for stroke are scarce in locations where infections are probably most common, making it difficult to reach conclusions on how populations differ in terms of risk of infectious stroke. The treatment of infections and stroke, when concomitant, is based on almost no evidence and requires dedicated efforts to understand variations that might exist. We highlight the present knowledge and emphasise the need for stronger evidence to assist in the diagnosis, treatment, and secondary prevention of stroke in patients in whom an infectious cause for stroke is probable.

Copyright © 2014 Elsevier Ltd. All rights reserved.

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