Acute Ischemic Stroke Patterns in Infective and Nonbacterial Thrombotic Endocarditis

• Aneesh B. Singhal

  From the Stroke Service, Department of Neurology, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass.

• Mehmet A. Topcuoglu

  From the Stroke Service, Department of Neurology, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass.

• Ferdinando S. Buonanno

  From the Stroke Service, Department of Neurology, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass.

書誌事項

タイトル別名

• A Diffusion-Weighted Magnetic Resonance Imaging Study

抄録

Background and Purpose — Although infective endocarditis (IE) and nonbacterial thrombotic endocarditis (NBTE) are associated with cardioembolic stroke, differences in the nature of these conditions may result in differences in associated stroke patterns. We compared patterns of acute and recurrent ischemic stroke in IE and NBTE, using diffusion-weighted MRI (DWI). Methods — Using ICD-9 diagnostic codes and medical record review, we identified 362 patients (387 episodes) with IE and 14 patients with NBTE. Thirty-five patients (with 27 episodes of IE, 9 NBTE) who underwent 36 initial and 29 follow-up DWI scans were selected for this study. DWI lesion size, number, and location were compared between groups and correlated with stroke syndromes and endocarditis features. Results — DWI was abnormal in all but 2 patients. Four acute stroke patterns were identified: (1) single lesion, (2) territorial infarction, (3) disseminated punctate lesions, and (4) numerous small (<10 mm) and medium (10 to 30 mm) or large (>30 mm) lesions in multiple territories. All patients with NBTE exhibited pattern 4, whereas those with IE exhibited patterns 1, 2, 3, and 4 (6, 2, 8 and 9 episodes, respectively). Seventy-five percent of patients with pattern 3 exhibited the clinical syndrome of embolic encephalopathy. Vegetation size, valve, and organisms had no correlation with stroke patterns. Conclusion — DWI has utility in differentiating between IE and NBTE. Patients with NBTE uniformly have multiple, widely distributed, small and large strokes, whereas patients with IE exhibit a panoply of stroke patterns.

収録刊行物

• Stroke

  Stroke 33 (5), 1267-1273, 2002-05

  Ovid Technologies (Wolters Kluwer Health)

キーワード

• Advanced and Specialized Nursing
• Cardiology and Cardiovascular Medicine
• Neurology (clinical)

詳細情報

• CRID: 1363670319133248000
• NII論文ID: 30022679468
• NII書誌ID: AA0085085X
• DOI: 10.1161/01.str.0000015029.91577.36
• ISSN: 15244628
• ISSN: 00392499
• Web Site: https://www.ahajournals.org/doi/full/10.1161/01.STR.0000015029.91577.36
• データソース種別:
  • Crossref
  • CiNii Articles