Neurological Complications of Infective Endocarditis

  • Filipa Dourado Sotero
  • Madalena Rosário
  • Ana Catarina Fonseca
  • José M. FerroEmail author
Neurology of Systemic Diseases (J. Biller, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurology of Systemic Disease


Purpose of Review

The purpose of this narrative review and update is to summarize the current knowledge and provide recent advances on the neurologic complications of infective endocarditis.

Recent Findings

Neurological complications occur in about one-fourth of patients with infective endocarditis. Brain MRI represents a major tool for the identification of asymptomatic lesions, which occur in most of the patients with infective endocarditis. The usefulness of systematic brain imaging and the preferred treatment of patients with infective endocarditis and silent brain lesions remains uncertain. The basis of treatment of infective endocarditis is early antimicrobial therapy. In stroke due to infective endocarditis, anticoagulation and thrombolysis should be avoided. Endovascular treatment can be useful for both acute septic emboli and mycotic aneurysms, but evidence is still limited. In patients with neurological complications, cardiac surgery can be safely performed early, if indicated.


The optimal management of a patients with neurological complications of infective endocarditis needs an individualized case discussion and the participation of a multidisciplinary team including neurologists, cardiologists, cardiothoracic surgeons, neuroradiologists, neurosurgeons, and infectious disease specialists.


Infective endocarditis Mycotic aneurysm Neurological complications Stroke Cardiac surgery Thrombectomy 


Compliance with Ethical Standards

Conflict of Interest

José M. Ferro reports grants from Bayer, personal fees from Boehringer Ingelheim, outside the submitted work. Filipa Dourado Sotero, Madalena Rosário, and Ana Catarina Fonseca each declares that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Filipa Dourado Sotero
    • 1
  • Madalena Rosário
    • 1
  • Ana Catarina Fonseca
    • 1
    • 2
  • José M. Ferro
    • 1
    • 2
    Email author
  1. 1.Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa MariaCentro Hospitalar Universitário Lisboa NorteLisbonPortugal
  2. 2.Faculdade de Medicina, Hospital de Santa MariaUniversidade de LisboaLisbonPortugal

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