Groll A, Hörlin A, Lang C, Jäger G, Jacobi G
Klinikum Johann Wolfgang Goethe-Universität Frankfurt.
Klin Padiatr. 1995 Jan-Feb;207(1):19-23. doi: 10.1055/s-2008-1046503.
Despite considerable progress in both diagnostic studies and therapeutic management serious complications of infectious endocarditis have become rather more common. Next to intracardiac complications arterial embolization to the central nervous system is the second most common life-threatening event, which might lead to infarction, hemorrhage, mycotic aneurysm and/or metastatic infection with a wide spectrum of neurological symptoms and an overall very poor prognosis. The most effective prevention of neurological complications is the early diagnosis of infectious endocarditis with isolation of the infecting agent and adequate antimicrobial chemotherapy in combination with well-timed cardiosurgical measures. Computed tomography and cerebral angiography is mandatory in any patient with neurological symptoms to check the need for a neurosurgical intervention as well as in patients assigned for anticoagulation for cardiac reasons.
尽管在诊断研究和治疗管理方面都取得了显著进展,但感染性心内膜炎的严重并发症却变得更加常见。仅次于心脏内并发症,中枢神经系统的动脉栓塞是第二常见的危及生命的事件,这可能导致梗死、出血、真菌性动脉瘤和/或转移性感染,伴有广泛的神经症状,总体预后非常差。预防神经并发症最有效的方法是早期诊断感染性心内膜炎,分离感染病原体并进行充分的抗菌化疗,同时结合适时的心脏外科手术措施。对于任何有神经症状的患者,以及因心脏原因需要抗凝的患者,计算机断层扫描和脑血管造影都是必要的,以检查是否需要神经外科干预。