Junna Mithri, Lin Chang-Ching D, Espinosa Raul E, Rabinstein Alejandro A
Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Mayo W8B, Rochester, MN 55905, USA.
Neurocrit Care. 2007;6(2):117-20. doi: 10.1007/s12028-007-0017-9.
Infective endocarditis can lead to serious neurological complications including ischemic stroke and intracranial hemorrhage. Treatment with intravenous thrombolysis within 3 h of symptom onset has become the standard of care in acute ischemic stroke, but the safety and efficacy of this intervention in patients with infective endocarditis is unknown.
We report the case of a patient with ischemic stroke who experienced substantial neurological improvement after being treated with intravenous thrombolysis (NIH stroke scale score of 15 on admission and 4 after treatment) and was subsequently found to have acute infective mitral endocarditis.
Favorable response to thrombolysis may occur in patients with stroke due to infectious endocarditis. The safety of this therapy remains to be established.
感染性心内膜炎可导致严重的神经并发症,包括缺血性卒中和颅内出血。症状发作后3小时内进行静脉溶栓治疗已成为急性缺血性卒中的治疗标准,但这种干预措施在感染性心内膜炎患者中的安全性和有效性尚不清楚。
我们报告了1例缺血性卒中患者,该患者在接受静脉溶栓治疗后神经功能有显著改善(入院时美国国立卫生研究院卒中量表评分为15分,治疗后为4分),随后被发现患有急性感染性二尖瓣心内膜炎。
感染性心内膜炎所致卒中患者可能对溶栓治疗有良好反应。这种治疗方法的安全性仍有待确定。