Pearls: Infectious stroke

1. For most infections, CSF exam is the tipoff
2. In syphilitic meningovascular disease, a branch of the MCA or aorta may be involved
3. HIV itself, coexisting syphilis or NBTE , fungal or zoster infections occur in HIV infected patients.
4. Zoster stroke in MCA distribution occurs several weeks after cutaneous zoster infection. Steroids are critical, and antiplatelet drugs also are used.
5. Cysticercosis has stroke in about ten percent, usually lacunes, CSF may be helpful, and treatment is with albendazole, praziquental, and steroids or occassionally surgery.
6. Mucormycosis has typical and dramatic presentation, but it can include cavernous sinus thrombosis with ICA occlusion and stroke. Signs of include bilateral exopthalmos, proptosis, chemosis, ocular impairments and visual loss.
7. Cat scratch disease due to bartonella can cause an arteritis and stroke