Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
Associate Professor, Emergency Medicine and Neurocritical Care, University of Cincinnati College of Medicine, Cincinnati, OH.
Emerg Med Pract. 2023 Mar;25(3):1-24. Epub 2023 Mar 1.
Stroke in patients with endocarditis is a unique, highly morbid condition requiring a high index of suspicion for diagnosis. This issue reviews the historical and physical examination factors that can provide clues to the etiology. The workup of these patients, involving both infection-focused and stroke-focused laboratory testing and neuroimaging, is discussed. The mainstay of treatment is empiric antibiotics, as thrombolytics are contraindicated. Recent evidence regarding the use of mechanical thrombectomy in largevessel occlusion strokes is discussed, as well as surgical options and consultation strategies with stroke, neurocritical care, infectious disease, and neurosurgery teams.
心内膜炎患者的脑卒中是一种独特的、高度病态的疾病，需要高度怀疑诊断。本问题回顾了可提供病因线索的历史和体检因素。讨论了这些患者的检查，包括感染和脑卒中为重点的实验室检查和神经影像学检查。治疗的主要方法是经验性使用抗生素，因为溶栓是禁忌的。还讨论了机械取栓术在大血管闭塞性脑卒中中的应用的最新证据，以及与脑卒中、神经危重症、感染病和神经外科团队的手术选择和咨询策略。
