Kareta S. Stroke-like presentation of infectious diseases of the CNS (clinical picture, diagnosis, treatment).

The dissertation is dedicated to aspects of clinical presentation and course, diagnosis, and treatment of infectious diseases of the CNS that are misdiagnosed as stroke, and to differential diagnosis of these conditions from acute cerebrovascular pathology.The dissertation elucidates peculiarities of CNS infections with stroke-like presentation such as meningitis, menigoencephalitis, encephalitis, and cerebral abscesses. A detailed analysis is given to their differences in presentation and course from typical forms of CNS infections, main variants of clinical course and neurological manifestations are described. Data of auxiliary laboratory and corresponding CAT and MRI neuroimaging techniques are presented.Based on analysis of the clinical data obtained the thesis indicates and analyzes factors leading to existence of and misdiagnosis of CNS infections as acute cerebrovascular pathology. Typical pitfalls in diagnosis are indicated. Important prognostic markers and their true significance are elucidated. The value of detailed case history, specific signs of somatic and neurological status, and findings of auxiliary laboratory and neuroimaging techniques is emphasized.The analysis of stroke-like cases of CNS infections made it possible to develop an effective algorithm of early diagnosis of CNS infections with stroke-like presentation and differential diagnosis of these conditions from acute cerebrovascular pathology. The algorithm determines groups of patients with high probability of CNS infection and provides a way to establish the fact of CNS infection per se and enables rapid diagnosis of concrete disease entities.Based on analysis of data obtained from histories of these patients, important elements of pathogenesis of stroke-like CNS infections and their dynamics, key aspects and appropriate approaches to medical management are indicated.