[Infectious endocarditis complicated with preoperative cerebral infarction and rupture of infectious intracranial aneurysm]

Abstract

A surgically treated case of infectious endocarditis (IE) complicated with preoperative cerebral infarction and rupture of mycotic intracranial aneurysm was reported. A 66-year-old male was admitted with the diagnosis of active IE due to Streptococcus sanguis, complicated with cerebral infarction 17 days previously. Preoperative echocardiography showed mobile vegetations both on the aortic and the mitral leaflet, sizes of which were 12.6 and 25 mm. The magnetic resonance imaging (MRI) demonstrated a subarachnoid homorrhage due to the rupture of an intracranial aneurysm, and was treated surgically. The bacteriological study of the resected aneurysm showed Streptococcus sanguis. Eleven days after the operation, both the aortic and the mitral valve replacement were performed. There were mobile vegetations on the aortic and the mitral leaflet. There were no new neurological findings after operation. The duration between the cranial surgery and the cardiac surgery was thought to be important to prevent the new neurological complication.