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When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis

Estabrak Jiad1, Sumanjit K Gill1,2, Maria Krutikov1

  • 1Department of Neurology, National Hospital for Neurology & Neurosurgery, Queen Square, London, UK.

Practical Neurology
|January 5, 2017
PubMed

Insights

Diagnosing infective endocarditis is challenging but crucial for stroke patients. Prompt treatment can be life-saving, despite diagnostic difficulties.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiology

Background:

  • Infective endocarditis (IE) presents significant diagnostic challenges, as noted by Sir William Osler in 1885.
  • Neurological complications, including stroke (cerebral infarction and intracranial hemorrhage), are common in IE.
  • Accurate diagnosis of IE is critical due to the risks associated with neurological complications.

Observation:

  • IE can manifest as ischemic stroke, posing a high risk of intracranial hemorrhage with thrombolysis.
  • IE-related intracerebral hemorrhage may involve mycotic aneurysms requiring urgent intervention.
  • Typical presentations of stroke secondary to IE are described.

Findings:

  • Modern diagnostic techniques still face challenges in identifying infective endocarditis.
  • Rapid diagnosis of IE is essential for effective management of neurological complications.
  • Treatment options for IE, including antibiotics and valve surgery, can be life-saving.

Implications:

  • Early detection and treatment of IE are vital to prevent severe neurological sequelae.
  • Understanding IE's neurological manifestations improves patient outcomes.
  • Further research into diagnostic and therapeutic controversies in IE is warranted.

Keywords:
EndocarditisInfectious DiseasesIntracerebral haemorrhageStroke

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