Kahn David Ethan, O'Phelan Kristine, Bullock Ross
Miller School of Medicine University of Miami, Department of Neurology, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136, USA.
Jackson Memorial Hospital, Department of Neurosurgery, 1095 NW 14th Ter No. 2, Miami, FL 33136-1060, USA.
Case Rep Crit Care. 2011;2011:428729. doi: 10.1155/2011/428729. Epub 2011 Jul 24.
Infectious endocarditis is frequently found in the neurologic intensive care unit and may rarely be the cause of intracranial hemorrhage. In such instances, further diagnostic imaging to search for an underlying structural lesion is prudent. Well-known causes of these hemorrhages include cardioembolism with hemorrhagic transformation, septic emboli, and mycotic aneurysms. We present a case of a patient who was admitted for routine evaluation and pain management of lumbar radiculopathy, who developed a large intraparenchymal hemorrhage and was found to have bacterial endocarditis. This was diagnosed retrospectively from positive hematoma cultures and a vegetation on transesophageal echocardiogram. Further evaluation revealed a mycotic aneurysm.
感染性心内膜炎在神经重症监护病房中很常见，很少会导致颅内出血。在这种情况下，进行进一步的诊断性影像学检查以寻找潜在的结构性病变是明智的。这些出血的常见原因包括伴有出血性转化的心脏栓塞、脓毒性栓子和真菌性动脉瘤。我们报告一例患者，该患者因腰椎神经根病的常规评估和疼痛管理入院，发生了大量脑实质内出血，经检查发现患有细菌性心内膜炎。这是根据血肿培养阳性和经食管超声心动图发现的赘生物进行回顾性诊断的。进一步评估发现了一个真菌性动脉瘤。
