Acute Ischemic or Hemorrhagic Stroke Syndromes

  • Arsovska Anita
  • Arsovski Zoran


Acute stroke is a medical emergency; it is the leading cause of adult physical disability and second most common cause of death worldwide. The two main stroke types are ischemic stroke that occurs in 80–85% of the cases and hemorrhagic stroke that occurs in 15–20%. According to the World Health Organization, there are 15 million people in the world who suffer from stroke every year. The risk factors for stroke (modifiable and nonmodifiable) have already been established and are well known; however, the presence of certain infections may add a higher risk. Fungal infections may cause cerebral vasculitis and lead to ischemic and/or hemorrhagic stroke. Histoplasma capsulatum, Rhizopus spp., Cryptococcus neoformans, and Exserohilum rostratum have been related to the occurrence of ischemic stroke, while Mucormycetes and Rhizopus spp. have been related to hemorrhagic stroke. Aspergillus spp. and Coccidioides immitis have been associated with the occurrence of both types of stroke. Appropriate neuroimaging and laboratory testing and even brain biopsy are needed to quickly establish the diagnosis. Medicamentous treatment of fungal infections causing stroke includes antifungal medications, corticosteroids, and prophylactic antiplatelet therapy in ischemic stroke; however, there are no randomized clinical trials that have evaluated their efficacy and safety. The prognosis is extremely poor for patients with fungal infections of the central nervous system presenting with acute ischemic or hemorrhagic strokes.


Fungal infections Central nervous system Acute ischemic stroke Acute hemorrhagic stroke Clinical syndromes Cerebral vasculitis 



Acquired immunodeficiency syndrome


Central nervous system


Cerebrospinal fluid


Computed tomography




Human immunodeficiency virus




Middle cerebral artery


Magnetic resonance


Recombinant tissue plasminogen activator


World Health Organization


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Arsovska Anita
    • 1
  • Arsovski Zoran
    • 2
  1. 1.University Clinic of Neurology, Medical FacultyUniversity of Ss. Cyril and MethodiusSkopjeMacedonia
  2. 2.University Clinic of Pulmonology and Allergy, Medical FacultyUniversity of Ss. Cyril and MethodiusSkopjeMacedonia

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