| Abstrakt: |
Introduction: Ischemic stroke has a heterogeneous and multifactorial etiology. Viral encephalitis represents an independent risk factor for a small proportion of cerebrovascular accidents. The formation of multiple thrombi in various brain vessels is characteristic of infection-induced strokes. Viral meningoencephalitis is most commonly caused by Herpes simplex virus (HSV) and is complicated by cerebrovascular accidents in only about 5.6% of cases. Objective: To present a clinical case of a female patient with thrombosis of both anterior and middle cerebral arteries due to meningoencephalitis caused by HSV types 1 and 2. Methods and materials: It concerns a 65-year-old female patient hospitalized for sudden weakness in the left limbs, preceded by general weakness, high fever, nausea and vomiting several days before. Her relatives also reported severe confusion with visual and auditory hallucinations at times, denying any such episodes in the past. Arterial hypertension is her only accompanying disease. Results: Objectively, there was a tendency for rightward head and gaze deviation, severe left-sided central hemiparesis, psycho-organic syndrome, and positive meningo-radicular irritation signs. Imaging studies of the head visualized thrombosis of both anterior and middle cerebral arteries with bilateral extensive hypodense areas in both cerebral hemispheres in the same phase of evolution. Due to the bilateral localization of the strokes, the psychoorganic syndrome and the positive meningo-radicular irritation, a decision was made to perform a lumbar puncture. The general cerebrospinal fluid examination revealed mild pleocytosis (18x106/l) and proteinrachia (0.74g/l), and the virological examination was positive for HSV type 1 and 2. Conclusion: In addition to the traditional risk factors for ischemic stroke, brain infections may also predispose them due to increased thrombus formation. Therefore, in the case of multiple bilateral strokes of approximately the same duration, it is necessary to rule out an infectious origin. [ABSTRACT FROM AUTHOR] |
