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Acute Cerebrovascular Ischemia and Infection

An original study published in Stroke investigated whether chronic or recurrent respiratory, ear nose throat (ENT), and dental infections are risk factors for cerebrovascular ischemia.
The authors, led by Armin J. Grau, MD, used a standardized questionnaire to investigate past infectious diseases in 166 consecutive patients with acute cerebrovascular ischemia and in 166 age- and sex-matched nonstroke neurological patient controls. In subgroups, standardized ENT (69 patients, 66 control subjects) and dental examinations including orthopantomography (66 patients, 60 control subjects) were performed. Dental status was determined by a total dental index that reflects caries, periapical lesions, periodontitis, and other dental lesions and by an orthopantomography index that was assessed blinded.
The study found that frequent (2 episodes in each of the 2 preceding years) or chronic bronchitis was associated with cerebrovascular ischemia in age-adjusted multiple logistic regression analysis. Groups were not different in ENT examination. Patients tended to have a worse dental status and had more severe periodontitis and periapical lesions than control subjects. In age-adjusted multiple logistic regression analysis with social status and established vascular risk factors, poor dental status was independently associated with cerebrovascular ischemia.
The study concludes that recurrent or chronic bronchial infection and poor dental status, mainly resulting from chronic dental infection, may be associated with an increased risk for cerebrovascular ischemia.
This study was entitled, "Association Between Acute Cerebrovascular Ischemia and Chronic and Recurrent Infection" and the authors are from the department of Neurology, department of Oral and Maxillofacial Surgery, department of Ear, Nose and Throat Medicine, department of Neurosurgery at the University of Heidelberg, and department of Epidemiology at the German Cancer Research Center in Heidelberg, Germany.

(Source: stroke.ahajournals.org/cgi/content/abstract/28/9/1724)

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