Imaging findings of the infective endocarditis with neurological complications

Rattabhorn Montrisaet; Sasitorn Petcharunpaisan

doi:10.46475/asean-jr.v25i1.876

Authors

Rattabhorn Montrisaet M.D. Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
Sasitorn Petcharunpaisan M.D. Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.

DOI:

https://doi.org/10.46475/asean-jr.v25i1.876

Keywords:

Cerebral infection, Infective endocarditis, Intracranial hemorrhage, Mycotic aneurysm, Stroke

Abstract

Neurological complications are the most serious extracardiac complications of infective endocarditis. They can be manifested as ischemic stroke, intracranial hemorrhage, mycotic aneurysms, meningitis, cerebritis and abscesses. Avoidance of anticoagulants and antiplatelet agents with early intravenous antibiotic administration is crucial in the management of this condition. MRI of the brain is an important tool for early diagnosis and guiding the treatment decision. The purpose of this article is to review the imaging appearances and the possible mechanisms of the intracranial findings in the patients with neurological complications of infective endocarditis.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Hu W, Wang X, Su G. Infective endocarditis complicated by embolic events: Pathogenesis and predictors. Clin Cardiol 2021;44:307-15. doi: 10.1002/clc.23554.

Ferro JM, Fonseca AC. Infective endocarditis. In: Biller J, Ferro JM, editors. Handbook of Clinical Neurology. Amsterdam: Elsevier; 2014. p. 75-91.

Chakraborty T, Rabinstein A, Wijdicks E. Neurologic complications of infective endocarditis. Handb Clin Neurol 2021;177:125-34. doi: 10.1016/B978-0-12-819814-8.00008-1.

Duval X, Iung B, Klein I, Brochet E, Thabut G, Arnoult F, et al. Effect of Early Cerebral Magnetic Resonance Imaging on Clinical Decisions in Infective Endocarditis. Ann Intern Med 2010;152:497-504. doi: 10.7326/0003-4819-152-8-201004200-00006.

Morris NA, Matiello M, Lyons JL, Samuels MA. Neurologic complications in infective endocarditis: identification, management, and impact on cardiac surgery. Neurohospitalist 2014;4:213-22. doi: 10.1177/1941874414537077.

Novy E, Sonneville R, Mazighi M, Klein IF, Mariotte E, Mourvillier B, et al. Neurological complications of infective endocarditis: new breakthroughs in diagnosis and management. Med Mal Infect 2013;43:443-50. doi: 10.1016/j.medmal.2013.09.010.

Asaithambi G, Adil MM, Qureshi AI. Thrombolysis for ischemic stroke associated with infective endocarditis: results from the nationwide inpatient sample. Stroke 2013;44:2917-9. doi: 10.1161/STROKEAHA.113.001602.

Derex L, Bonnefoy E, Delahaye F. Impact of stroke on therapeutic decision making in infective endocarditis. J Neurol 2010;257:315-21. doi: 10.1007/s00415-009-5364-3.

Hess A, Klein I, Iung B, Lavallee P, Ilic-Habensus E, Dornic Q, et al. Brain MRI findings in neurologically asymptomatic patients with infective endocarditis. AJNR Am J Neuroradiol 2013;34:1579-84. doi: 10.3174/ajnr.A3582.

Azuma A, Toyoda K, O'Uchi T. Brain magnetic resonance findings in infective endocarditis with neurological complications. Jpn J Radiol 2009;27:123-30. doi: 10.1007/s11604-008-0308-x.

Champey J, Pavese P, Bouvaist H, Kastler A, Krainik A, Francois P. Value of brain MRI in infective endocarditis: a narrative literature review. Eur J Clin Microbiol Infect Dis 2016;35:159-68. doi: 10.1007/s10096-015-2523-6.