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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Mechanical Thrombectomy for Acute Ischemic Stroke Complicated by Bacterial Meningitis and Infective Endocarditis

Masaaki Kubota1,2, Eiichi Kobayashi1,2, Yoichi Yoshida1,2

  • 1Comprehensive Stroke Center, Chiba University Hospital, Chiba, Chiba, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed
Abstract

Insights

Infective endocarditis (IE) can cause bacterial meningitis and cerebral embolism. This case highlights the importance of considering IE in patients with acute ischemic stroke and meningitis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiology

Background:

  • Bacterial meningitis can lead to serious complications, including stroke.
  • Infective endocarditis (IE) is a serious infection of the heart valves that can cause embolic events.

Observation:

  • An 82-year-old woman with bacterial meningitis developed a left middle cerebral artery embolism during treatment.
  • Mechanical thrombectomy successfully retrieved yellowish-white emboli.
  • Culture and pathological findings identified *Streptococcus gordonii* in the emboli, matching the meningitis pathogen and suggesting IE as the source.

Findings:

  • The retrieved emboli were confirmed to be bacterial, originating from infective endocarditis.
  • The patient experienced slight right hemiparesis post-procedure.

Implications:

  • This case underscores the critical need to consider bacterial embolism from IE in patients presenting with acute ischemic stroke concurrent with bacterial meningitis.
  • Early recognition and management of IE are crucial to prevent severe neurological sequelae.
Keywords:
cerebral embolismStreptococcus gordoniibacterial meningitisinfective endocarditismechanical thrombectomy

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