Subarachnoid hemorrhage due to septic embolic infarction in infective endocarditis.
During antibiotic therapy, a 56-year-old man with a Streptococcus bovis endocarditis developed an infarction of the right middle cerebral artery (MCA). Thirty hours after stroke onset, cranial computed tomography controls demonstrated a secondary subarachnoid hemorrhage, marked in the cistern of the right MCA. The latent period, cerebrospinal fluid analysis, angiographic and pathologic findings favor the assumption of a pyogenic arterial wall necrosis of the MCA due to a septic embolus. This pathomechanism of intracranial hemorrhage in infective endocarditis should be distinguished from a rupture of a mycotic aneurysm.
Krapf
H
H
Department of Neuroradiology, University of Tübingen, Germany.
Skalej
M
M
Voigt
K
K
D002544:Cerebral Infarction / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology*; D016985:Streptococcus bovis / Q000302:isolation & purification; D013345:Subarachnoid Hemorrhage / Q000382:microbiology*; D014057:Tomography, X-Ray Computed