Bacterial Endocarditis and Cerebrovascular Disease

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• 作者：Brian Silver ; Réza Behrouz ; Scott Silliman
• 关键词：Stroke ; Endocarditis ; Review
• 刊名：Current Neurology and Neuroscience Reports
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：16
• 期：12
• 全文大小：258 KB
• 刊物主题：Neurology; Neurosciences;
• 出版者：Springer US
• ISSN：1534-6293
• 卷排序：16

文摘

Cerebrovascular complications of endocarditis occur in 25–70% of patients with infective endocarditis. The cornerstone of treatment is early initiation of antibiotic treatment, which significantly reduces the risk of embolization after 1 week of treatment. In general, thrombolysis and anticoagulation of these patients should be avoided, while antiplatelet therapy may be considered in those with other indications. Endovascular treatment of acute septic emboli is uncertain, but a few case reports have demonstrated benefit. Other complications of infective endocarditis include intracerebral hemorrhage, which may be predicted by the presence of two or more cerebral microbleeds on gradient echo sequences. Intracranial mycotic aneurysms can often be managed with serial imaging and coiled if there is evidence of failure to reduce in size, or enlargement.