Back to Search
Start Over
Abstract WP331: Intracranial Hemorrhage in Infective Endocarditis: Underlying Arterial and Parenchymal Disease
- Source :
- Stroke. 49
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Introduction: Intracranial hemorrhage (ICH) is a known complication of infective endocarditis (IE). We aimed to explore radiologic findings that may explain the cause of ICH and the prognosis of these patients. Methods: We reviewed records of infective endocarditis cases with intraparenchymal hemorrhage (IPH) and subarachnoid hemorrhage (SAH) who underwent magnetic resonance imaging (MRI) and cerebral angiography at a single tertiary center from 2010 to 2014. All patients fulfilled modified Duke’s criteria for infective endocarditis. Results: We identified 36 patients our inclusion criteria. Eleven (30%) had IPH only, 10 (28%) had SAH, and 15 (42%) had both. The most common presenting symptoms were focal neurological deficit (39%, n=14), encephalopathy (25%, n=9), followed by headache (19%, n=7). The hemorrhage was silent in (19%, n=7) cases. Twelve patients (33%) had mycotic aneurysms but only 4 had evidence of rupture (11%). Ten (28%) had distal arterial irregularities on angiography suggestive of vasculitis. Thirteen (36%) had evidence of microabscesses on MRI, and 22 (61%) had cerebral ischemia on MRI, of which 6 had a hemorrhagic transformation. In 24 out of 25 SAH cases cortical sulcal hemorrhage was seen and only one SAH was in the basal cistern. In 14 (56%) of these cortical SAHs had adjacent restricted diffusion lesion on the MRI. Among 21 patients undergoing valvular repair, only 2 (1%) were complicated with new intracranial hemorrhage that had no relation to the presence of microhemorrhages on MRI (p=0.42). Conclusion: Intracranial hemorrhage in infective endocarditis is rarely related to mycotic aneurysms. Parenchymal involvement of infection or vascular inflammation may be the underlying causes for IPH and SAH in these patients.
Details
- ISSN :
- 15244628 and 00392499
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi...........f8493fd626b24f7e8d87071f7880a42f
- Full Text :
- https://doi.org/10.1161/str.49.suppl_1.wp331