Related Experiment Video

Updated: Aug 6, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
09:01

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

Infective Endocarditis Presenting with Rapidly Progressive Cerebral Microbleeds and Multiple Intracerebral

Kazumasa Sekiguchi1, Jun Sawada1, Kosuke Matsuzono1

  • 1Division of Neurology, Department of Medicine, Jichi Medical University, Japan.

Internal Medicine (Tokyo, Japan)
|July 20, 2026
PubMed

Insights

Infective endocarditis (IE) can cause multiple brain hemorrhages, especially in patients on anticoagulants. Prompt antibiotic treatment led to a favorable outcome in this case of IE with Streptococcus mitis/oralis.

Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a significant cause of neurological complications.
  • Hemorrhagic stroke, including intracerebral hemorrhages (ICHs) and cerebral microbleeds (CMBs), can occur in IE patients.
  • Patients with prosthetic heart valves on anticoagulant therapy are at increased risk.

Purpose of the Study:

  • To highlight the association between IE, anticoagulant therapy, and multiple cerebral hemorrhages.
  • To emphasize the importance of considering IE in the differential diagnosis of multiple ICHs and CMBs.
  • To report a case of IE with Streptococcus mitis/oralis presenting with multiple ICHs and CMBs.

Main Methods:

  • Case report of a 65-year-old male patient.
  • Diagnosis of IE based on clinical presentation and microbiological findings.
  • Imaging studies to identify intracerebral hemorrhages and cerebral microbleeds.

Main Results:

  • The patient developed multiple ICHs and CMBs.
  • IE was diagnosed and attributed to Streptococcus mitis/oralis.
  • The patient recovered fully with antibiotic treatment alone.

Conclusions:

  • IE should be considered in patients presenting with multiple cerebral hemorrhages, particularly those on anticoagulant therapy.
  • Anticoagulant therapy may exacerbate or contribute to the development of multiple ICHs and CMBs in the context of IE.
  • Early diagnosis and appropriate antibiotic treatment of IE are crucial for favorable neurological outcomes.

Keywords:
cerebral microbleedinfective endocarditisoral anticoagulant

More Related Videos

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model09:14

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

Related Concept Videos

Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...