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Staphylococcus Endocarditis Associated with Infectious Vasculitis and Recurrent Cerebral Hemorrhages

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Abstract

Background

Patients with infectious endocarditis, who do not respond to conservative medical therapy usually need rapid valve surgery. This poses a difficult dilemma in patients with intracranial aneurysms and hemorrhage, although endovascular treatment of infectious aneurysms might be an advantage in therapy in these patients.

Methods

We present a patient with ruptured infectious intracranial aneurysm complicating endocarditis with hemorrhage after successful coil occlusion of the aneurysm and review the literature on studies reporting endovascular treatment in adults with infectious aneurysms.

Results

In total 34 adults have been reported with endovascular treatment of infectious aneurysms. All patients were initially presented with hemorrhage. Reported mortality rate was low (6%), and neurologic disability was reported in 37% of other patients. Rehemorrhage has been described in one other patient after endovascular treatment of an infectious aneurysm after rupture of a new aneurysm. In our patient, CT suggested a generalized cerebral infectious vasculitis.

Conclusions

Endovascular treatment of infectious aneurysms seems to be a great advantage, but endovascular coiling may not prevent hemorrhage associated with panvasculitis rupture of a new aneurysm.

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Acknowledgements

D. van de Beek is supported by personal grants of the Netherlands Organization for Health Research and Development (ZonMw) [NWO-Veni grant 2006 (916.76.023), NWO-Rubicon grant 2006 (019.2006.1.310.001)], and the Dr. Jan Meerwaldt Foundation.

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Authors and Affiliations

  1. Division of Critical Care Neurology, Department of Neurology, Mayo Clinic College of Medicine, W8B, 200 First Street SW, Rochester, MN, 55905, USA

    Diederik van de Beek, Alejandro A. Rabinstein & Eelco F. M. Wijdicks

  2. Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    Steve G. Peters

  3. Division of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Harry Cloft

Authors
  1. Diederik van de Beek
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  2. Alejandro A. Rabinstein
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  3. Steve G. Peters
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  4. Harry Cloft
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  5. Eelco F. M. Wijdicks
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Corresponding author

Correspondence to Eelco F. M. Wijdicks.

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van de Beek, D., Rabinstein, A.A., Peters, S.G. et al. Staphylococcus Endocarditis Associated with Infectious Vasculitis and Recurrent Cerebral Hemorrhages. Neurocrit Care 8, 48–52 (2008). https://doi.org/10.1007/s12028-007-9002-6

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  • DOI: https://doi.org/10.1007/s12028-007-9002-6

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