Satsu Takuma, Onoe M, Kajiwara M, Yamashita K, Izuhara M
Department of Cardiovascular Surgery, Kishiwada City Hospital, Japan.
Kyobu Geka. 2010 Jan;63(1):82-5.
A 38-year-old man was hospitalized complaining of an episode of syncope. He was diagnosed with acute infective endocarditis (IE) of the aortic and the mitral valves with mobile and large vegetations, complicated with mycotic cerebral emboli related to the left anterior and the middle cerebral arteries. Double valve replacement with mechanical prosthesis was performed within 24 hours after cerebral accident occurred. On the 36 postoperative day, emergency cerebrovascular surgery was done due to rupture of a mycotic intracranial aneurysm. He was discharged on foot without any neurological abnormal finding. The optimum treatment of IE complicated with cerebral embolism is a controversial theme. Management should be considered carefully in individual cases.
一名38岁男性因晕厥发作入院。他被诊断为主动脉瓣和二尖瓣急性感染性心内膜炎(IE),伴有活动的大赘生物,并伴有与左大脑前动脉和大脑中动脉相关的霉菌性脑栓塞。在脑部意外发生后24小时内进行了机械瓣膜双瓣置换术。术后第36天,因霉菌性颅内动脉瘤破裂进行了急诊脑血管手术。他出院时步行,无任何神经学异常发现。IE合并脑栓塞的最佳治疗是一个有争议的主题。应在个别病例中仔细考虑治疗方案。