Catastrophic Multiple Microbleeds Caused by Infective Endocarditis Following Intravenous Thrombolysis and Endovascular Thrombectomy
| Autor: | Hiroyuki Nakase, Ichiro Nakagawa, Ryosuke Maeoka, Hideyuki Ohnishi, Kenkichi Takahashi, Hiroyuki Ohnishi |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Brain Ischemia 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Thrombolytic Therapy Acute ischemic stroke Thrombectomy medicine.diagnostic_test business.industry Endovascular Procedures Rehabilitation Magnetic resonance imaging Endocarditis Bacterial Thrombolysis Middle Aged medicine.disease Cerebral Angiography Stroke Diffusion Magnetic Resonance Imaging Treatment Outcome Hemorrhagic complication Infective endocarditis Ischemic stroke Cardiology Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business Intracranial Hemorrhages Magnetic Resonance Angiography 030217 neurology & neurosurgery After treatment Large vessel occlusion |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 28:e123-e125 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2019.06.004 |
| Popis: | Ischemic stroke is one of the most common complications of infective endocarditis (IE). IE must be considered as one of the causes of acute ischemic stroke (AIS) with emergent large vessel occlusion (ELVO), but early diagnosis of IE is difficult. AIS with ELVO must be treated using endovascular thrombectomy (EVT), with or without intravenous thrombolysis (IVT). IVT for AIS due to IE is not well established and remains controversial because of the risk of intracranial hemorrhage. A 42-year-old man suffered from right hemiparesis and disorientation, and AIS with ELVO was diagnosed. EVT with IVT was successfully performed and recanalization was achieved, but catastrophic multiple cerebral microbleeds appeared after treatment. EVT without IVT could be chosen for AIS caused by IE to avoid hemorrhagic complications. Hypointense signal spots on T2*-weighted magnetic resonance imaging (MRI) and susceptibility-weighted MRI could facilitate early diagnosis of IE. |
| Databáze: | OpenAIRE |
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