[Cerebral artery lesion in a patient with infective endocarditis: serial MRI and MRA findings of cerebral artery stenosis].
We reported a case of infective endocarditis (IE) complicated with bacterial meningitis and cerebral artery stenosis. A 22-year-old man was admitted to our hospital because of IE. Although benzylpenicillin administration was continued, he abruptly developed consciousness disturbance on the seventh day. His cerebrospinal fluid indicated bacterial meningitis. MRI with gadolinium (Gd) enhancement showed septic embolism in the left parietal lobe and bi-linear enhancement on the right middle cerebral artery (MCA). MRA demonstrated narrowing of the MCA at the same site as the bi-linear Gd enhancement. We considered that these findings show narrowing of the MCA was due to cerebral arteritis. Intravenous administration of ampicillin and cefpirome gradually improved both IE and cerebral artery stenosis. We wish to emphasize that combination of MRI with Gd enhancement and MRA may be useful not only for diagnosis of cerebral artery stenosis but also for evaluation of treatment effect.
Taguchi
Yoshiharu
Y
Department of Neurology, Toyama University Hospital, 2630 Sugitani, Toyama 930-0194, Japan.
Takashima
Shutaro
S
Noguchi
Kyo
K
Dougu
Nobuhiro
N
Tanaka
Koutaro
K
D000328:Adult; D002539:Cerebral Arterial Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D003251:Constriction, Pathologic; D004697:Endocarditis, Bacterial / Q000150:complications*; D005682:Gadolinium; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography
D005682:Gadolinium