Clinical study of stroke related to infective endocarditis

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  • 感染性心内膜炎に伴う脳卒中の臨床的検討

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Purpose: To elucidate the characteristics of stroke related to infective endocarditis (IE), we retrospectively reviewed the records of patients with IE at our hospital. Methods: Ninety patients with IE (mean age 63.8 ± 17.4 years) were selected in this study, and neuroradiological findings and background factors related to stroke were evaluated in all subjects with stroke. Results: Of the 90 subjects with IE, 25 (28%) had stroke (18 cerebral infarctions, 5 intracerebral hemorrhages, and 2 subarachnoid hemorrhages). Subjects with a modified Rankin scale ≥3 at discharge were significantly more prevalent in the stroke group than in the non-stroke group (52% vs. 28%, P = 0.046). The majority of cerebral infarctions were detected in the territory supplied by the cerebral cortical branches. Intracerebral hemorrhages were found with multiple hematomas in the subcortical or cerebellar regions. Cerebral infarctions mainly occurred in the initial stage of IE, and intracerebral hemorrhage or subarachnoid hemorrhage developed after the appearance of several physical symptoms of IE. Conclusion: Stroke occurred in almost one-third of IE patients. In particular, ischemic stroke occurred in the initial stage of IE.

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