Imaging of cerebrovascular complications of infection

Abstract

Cerebrovascular complications may occur in infectious diseases in the setting of infective endocarditis, central nervous system (CNS) infections, systemic bacteremia and sepsis. Cerebrovascular complications of infections include vasculitis, mycotic aneurysms, and thrombophlebitis. Infectious vasculitis of the CNS may cause cerebral hemorrhage, infarction or ischemia. Ruptured aneurysms may endanger the patient's life. Infectious thrombophlebitis may cause intracranial pressure to increase and lead to cerebral hemorrhage. These cerebrovascular complications are associated with a poor prognosis and often cause irreversible neurological deficits. Cerebrovascular events secondary to infection are not easily distinguishable from the more common cerebral infarct and non-infectious vasculitis. In addition, the clinical manifestations of cerebrovascular complications of infections are non-specific and highly variable. Therefore, early imaging, antibiotics, and anticoagulation may be lifesaving the patient’s life and prevent disability. The main focus of this article is to review imaging analysis of the cerebrovascular complications of infections and imaging features that help differentiate them from non-infectious vascular diseases.