Middle cerebral artery occlusion after recent mycoplasma pneumoniae infection

Fu, Michael; Wong, Ka Sing; Lam, Wynnie W. M.; Wong, Gary

doi:10.1016/s0022-510x(98)00074-4

Cited by 52 publications

(40 citation statements)

References 8 publications

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“…Stroke can occur in children [Fu et al, 1998;Lee et al, 2009;Leonardi et al, 2005;Ovetchkine et al, 2002;Parker et al, 1981;Tanir et al, 2006;Visudhiphan et al, 1992] as well as in adults [Mulder & Spierings, 1987;Padovan et al, 2001;Senda et al, 2010;Snowden et al, 1990;Sočan et al, 2001;Sotgiu et al, 2003]. The middle cerebral arteries are most often affected [Fu et al, 1998;Leonardi et al, 2005;Mulder & Spierings, 1987;Parker et al, 1981;Senda et al, 2010;Sotgiu et al, 2003], though the internal carotid arteries are affected in a few cases Tanir et al, 2006;Visudhiphan et al, 1992].…”

Section: Strokementioning

confidence: 99%

“…The middle cerebral arteries are most often affected [Fu et al, 1998;Leonardi et al, 2005;Mulder & Spierings, 1987;Parker et al, 1981;Senda et al, 2010;Sotgiu et al, 2003], though the internal carotid arteries are affected in a few cases Tanir et al, 2006;Visudhiphan et al, 1992]. Although the presence of systemic hypercoagulable state has been reported in a few cases, evidenced by disseminated intravascular coagulation [Mulder & Spierings, 1987] or by the production of antiphospholipid (anticardiolipin) antibodies [Senda et al, 2010;Snowden et al, 1990;Tanir et al, 2006], most cases occur in the absence of such conditions.…”

Section: Strokementioning

confidence: 99%

See 1 more Smart Citation

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

Narita¹

2011

Advances in the Etiology, Pathogenesis and Pathology of Vasculitis

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Section: Strokementioning

confidence: 99%

Section: Strokementioning

confidence: 99%

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

Narita¹

2011

Advances in the Etiology, Pathogenesis and Pathology of Vasculitis

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“…Focal middle cerebral artery vasculitis has also been implicated in stroke associated with Mycoplasma pneumoniae infection (Fu et al, 1998). Intraneuronal migration of the varicella zoster virus from the trigeminal ganglion along the trigeminal nerve to the cerebral arteries has been proposed as a reasonable mechanism for varicella-associated ischemic stroke (Askalan et al, 2001).…”

Section: Physical and Circulatory Mechanismsmentioning

confidence: 99%

Inflammation and Infection in Clinical Stroke

Emsley

Tyrrell

2002

J Cereb Blood Flow Metab

202

126

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Summary:Stroke has enormous clinical, social, and economic implications, and demands a significant effort from both basic and clinical science in the search for successful therapies. Atherosclerosis, the pathologic process underlying most coronary artery disease and the majority of ischemic stroke in humans, is an inflammatory process. Complex interactions occur between the classic risk factors for atherosclerosis and its clinical consequences. These interactions appear to involve inflammatory mechanisms both in the periphery and in the CNS. Central nervous system inflammation is important in the pathophysiologic processes occurring after the onset of cerebral ischemia in ischemic stroke, subarachnoid hemorrhage, and head injury. In addition, inflammation in the CNS or in the periphery may be a risk factor for the initial development of cerebral ischemia. Peripheral infection and inflammatory processes are likely to be important in this respect. Thus, it appears that inflammation may be important both before, in predisposing to a stroke, and afterwards, where it is important in the mechanisms of cerebral injury and repair. Inflammation is mediated by both molecular components, including cytokines, and cellular components, such as leukocytes and microglia, many of which possess pro-and/or antiinflammatory properties, with harmful or beneficial effects. Classic acute-phase reactants and body temperature are also modified in stroke, and may be useful in the prediction of events, outcome, and as therapeutic targets. New imaging techniques are important clinically because they facilitate in vivo dynamic evaluation of tissue damage in relation to outcome. Inflammatory conditions such as giant cell arteritis and systemic lupus erythematosus predispose to stroke, as do a range of acute and chronic infections, principally respiratory. Diverse mechanisms have been proposed to account for inflammation and infection-associated stroke, ranging from classic risk factors to disturbances of the immune and coagulation systems. Considerable opportunities therefore exist for the development of novel therapies. It seems likely that drugs currently used in the treatment of stroke, such as aspirin, statins, and modulators of the renin-angiotensin-aldosterone system, act at least partly via antiinflammatory mechanisms. Newer approaches have included antimicrobial and antileukocyte strategies. One of the most promising avenues may be the use of cytokine antagonism, for example, interleukin-1 receptor antagonist.

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“…In addition, M. pneumoniae has also been detected in atherosclerotic specimens [11, 12, 13, 14]. Although M. pneumoniae is known to cause central nervous system diseases [5, 28, 31], specific association between M. pneumoniae and acute cerebrovascular disease was limited to case reports involving mainly younger patients [15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28]. …”

Section: Discussionmentioning

confidence: 99%

“…Specifically, a positive association between M. pneumoniae infection and cerebrovascular disease has also been reported [15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28]. These reports are limited to a number of clinical case studies involving mainly paediatric and younger patients.…”

Section: Introductionmentioning

confidence: 99%

<i>Mycoplasma pneumoniae</i> in Elderly Patients with Stroke

Ngeh¹,

Gupta²,

Goodbourn³

et al. 2004

Cerebrovasc Dis

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Background and Purpose: Previous studies have suggested certain infections as potential risk factors for stroke. Chlamydia pneumoniae, an atypical respiratory pathogen, has been linked to atherosclerotic vascular diseases. Mycoplasma pneumoniae, another atypical respiratory micro-organism, can rarely cause stroke. We investigated whether serological markers of M. pneumoniae infection were associated with acute stroke or transient ischaemic attack (TIA) in elderly patients. Methods: This case-control study was nested within the C-PEPS study – a case-control study on the seroprevalence of C. pneumoniae in elderly stroke and medical patients. Ninety-five incident cases of patients admitted consecutively with acute stroke or TIA, and 82 control subjects admitted concurrently with acute non-cardiopulmonary, non-infective disorders, were included in this study (both groups aged 65 years or older). Using commercial enzyme-linked immunosorbent assay (ELISA) kits, the presence of M. pneumoniae immunoglobulins IgA, IgG and IgM in patients’ sera was determined. Results: The seroprevalence of M. pneumoniae IgA, IgG and IgM in the stroke or TIA group (median age = 80) were 79, 61 and 6%, respectively. In the control group (median age = 80), the seroprevalence of respective M. pneumoniae IgA, IgG and IgM were 84, 50 and 11%. Using a logistic regression statistical model, adjusting for history of hypertension, smoking, diabetes mellitus, age and sex, history of ischaemic heart disease, and ischaemic electrocardiogram, the odds ratios of having a stroke or TIA in relation to M. pneumoniae IgA, IgG and IgM were 0.63 (95% confidence interval (CI) = 0.26–1.52, p = 0.31), 1.32 (95% CI = 0.66–2.64, p = 0.43) and 0.52 (95% CI = 0.14–1.92, p = 0.32), respectively. Conclusions: The study showed a high seroprevalence of M. pneumoniae in an elderly hospital population, using ELISA. Although the study ruled out M. pneumoniae seropositivity as a major risk factor for stroke in this elderly population, a smaller effect could not be excluded due to the small sample size. Future larger studies may be required to determine the precise role of M. pneumoniae infection in the pathogenesis of different subtypes of ischaemic stroke, in all age groups, and in different ethnic populations.

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Middle cerebral artery occlusion after recent mycoplasma pneumoniae infection

Cited by 52 publications

References 8 publications

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

Inflammation and Infection in Clinical Stroke

<i>Mycoplasma pneumoniae</i> in Elderly Patients with Stroke

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