Department of Pediatrics, Saitama Medical Center, Saitama Medical University.
Department of Cardiovascular Surgery, Saitama Medical Center, Saitama Medical University.
Int Heart J. 2021 Jan 30;62(1):216-219. doi: 10.1536/ihj.20-474. Epub 2021 Jan 16.
A 14 year-old boy developed infective endocarditis of the mitral valve caused by Methicillin-sensitive Staphylococcus aureus and became comatose. Isolated basilar artery dissection was initially observed on the 3rd day by magnetic resonance imaging (MRI), ie, it did not exist on day 1. He underwent successful urgent mitral valve repair on the 5th day because of highly mobile vegetations and a newly emerged brain infarction under optimal antibiotic administration. Postoperatively, he recovered well and the basilar artery dissection was found to have recovered on an MRI on the 25th day without any specific intervention. This clinical course indicated that intracranial artery dissection may occur as a complication of infective endocarditis and supports the importance of the careful evaluation of brain MRI in patients with infective endocarditis.
一位 14 岁男孩因耐甲氧西林金黄色葡萄球菌引起感染性心内膜炎导致二尖瓣感染，并陷入昏迷。3 天时通过磁共振成像（MRI）首次发现孤立性基底动脉夹层，即第一天时不存在基底动脉夹层。在接受最佳抗生素治疗的情况下，第 5 天因活动性高的赘生物和新出现的脑梗死，成功进行紧急二尖瓣修复。术后，他恢复良好，基底动脉夹层在第 25 天的 MRI 上显示已恢复，没有任何特定的干预。这一临床过程表明，颅内动脉夹层可能是感染性心内膜炎的并发症之一，支持在感染性心内膜炎患者中仔细评估脑 MRI 的重要性。
