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[Infectious endocarditis complicated with preoperative cerebral infarction and rupture of infectious intracranial

H Sugiki1, N Shiiya, T Murashita

  • 1Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|January 31, 2006
PubMed

Insights

This case report details infectious endocarditis (IE) with cerebral infarction and mycotic aneurysm rupture. Surgical timing between cranial and cardiac procedures is crucial for preventing neurological complications.

Area of Science:

  • Cardiology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Infectious endocarditis (IE) poses significant risks, including embolic events and neurological complications.
  • Mycotic intracranial aneurysms are a rare but severe manifestation of IE.
  • Cerebral infarction and aneurysm rupture present complex management challenges in IE patients.

Observation:

  • A 66-year-old male with Streptococcus sanguis IE presented with prior cerebral infarction.
  • Echocardiography revealed large vegetations on aortic and mitral valves.
  • MRI confirmed subarachnoid hemorrhage from a ruptured intracranial aneurysm, requiring surgical intervention.

Findings:

  • Bacteriological analysis of the resected aneurysm identified Streptococcus sanguis.
  • Aortic and mitral valve replacement was successfully performed 11 days post-neurosurgery.
  • No new neurological deficits were observed postoperatively.

Implications:

  • This case highlights the critical importance of the interval between cranial and cardiac surgery in managing IE with neurological complications.
  • Optimizing surgical sequencing may mitigate risks of secondary neurological events.
  • Multidisciplinary management is essential for complex IE cases involving cerebrovascular complications.

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