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Two new studies address the issue of the mechanism of death after acute ischemic stroke.
In 75 patients admitted for acute, noninfectious ischemic stroke, Chamorro and colleagues prospectively measured (1 day after admission) two serum markers of sympathetic nervous system activation (metanephrine and normetanephrine) and various serum markers of immune activation (interleukin-6 and -10, tumor necrosis factor alpha, and monocytes and lymphocytes). In a multivariate analysis, infection that developed between hospital admission and day 7 was associated with sympathetic activation (high metanephrine levels), increased monocyte count, and increased interleukin-10 levels. Mortality at 3 months was associated with high metanephrine levels, the sev…