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Published in: Journal of Neurology 5/2013

01-05-2013 | Original Communication

Thrombolysis for stroke caused by infective endocarditis: an illustrative case and review of the literature

Authors: Elodie Ong, Laura Mechtouff, Emilien Bernard, Tae-Hee Cho, Lansana Laho Diallo, Norbert Nighoghossian, Laurent Derex

Published in: Journal of Neurology | Issue 5/2013

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Abstract

Infective endocarditis represents a classical contra-indication to thrombolysis for acute ischemic stroke due to a potential increased risk of intracranial hemorrhage. However, some case reports have suggested safety and potential efficacy of intravenous or intra-arterial thrombolysis in stroke related to infective endocarditis. We present a case of ischemic stroke related to infective endocarditis who was treated with intravenous tissue plasminogen activator within the first 3 h of symptoms onset and subsequently developed symptomatic multifocal intracerebral hemorrhages, and summarize currently available data on this issue.
Literature
1.
go back to reference Derex L, Bonnefoy E, Delahaye F (2010) Impact of stroke on therapeutic decision making in infective endocarditis. J Neurol 257(3):315–321PubMedCrossRef Derex L, Bonnefoy E, Delahaye F (2010) Impact of stroke on therapeutic decision making in infective endocarditis. J Neurol 257(3):315–321PubMedCrossRef
2.
go back to reference Ruttmann E, Willeit J, Ulmer H, Chevtchik O, Höfer D, Poewe W, Laufer G, Müller LC (2006) Neurological outcome of septic cardioembolic stroke after infective endocarditis. Stroke 37(8):2094–2099PubMedCrossRef Ruttmann E, Willeit J, Ulmer H, Chevtchik O, Höfer D, Poewe W, Laufer G, Müller LC (2006) Neurological outcome of septic cardioembolic stroke after infective endocarditis. Stroke 37(8):2094–2099PubMedCrossRef
3.
go back to reference Siccoli M, Benninger D, Schuknecht B, Jenni R, Valavanis A, Bassetti C (2003) Successful intra-arterial thrombolysis in basilar thrombosis secondary to infectious endocarditis. Cerebrovasc Dis 16(3):295–297PubMedCrossRef Siccoli M, Benninger D, Schuknecht B, Jenni R, Valavanis A, Bassetti C (2003) Successful intra-arterial thrombolysis in basilar thrombosis secondary to infectious endocarditis. Cerebrovasc Dis 16(3):295–297PubMedCrossRef
4.
go back to reference Junna M, Lin CC, Espinosa RE, Rabinstein AA (2007) Successful intravenous thrombolysis in ischemic stroke caused by infective endocarditis. Neurocrit Care 6(2):117–120PubMedCrossRef Junna M, Lin CC, Espinosa RE, Rabinstein AA (2007) Successful intravenous thrombolysis in ischemic stroke caused by infective endocarditis. Neurocrit Care 6(2):117–120PubMedCrossRef
5.
go back to reference Tan M, Armstrong D, Birken C, Bitnun A, Caldarone CA, Cox P, Kahr W, Macgregor D, Askalan R (2009) Bacterial endocarditis in a child presenting with acute arterial ischemic stroke. Should thrombolytic therapy be absolutely contraindicated? Dev Med Child Neurol 51(2):151–154PubMedCrossRef Tan M, Armstrong D, Birken C, Bitnun A, Caldarone CA, Cox P, Kahr W, Macgregor D, Askalan R (2009) Bacterial endocarditis in a child presenting with acute arterial ischemic stroke. Should thrombolytic therapy be absolutely contraindicated? Dev Med Child Neurol 51(2):151–154PubMedCrossRef
6.
go back to reference Sontineni SP, Mooss AN, Andukuri VG, Schima SM, Esterbrooks D. Effectiveness of thrombolytic therapy in acute embolic stroke due to infective endocarditis. Stroke Res Treat. 2010. 841797] Sontineni SP, Mooss AN, Andukuri VG, Schima SM, Esterbrooks D. Effectiveness of thrombolytic therapy in acute embolic stroke due to infective endocarditis. Stroke Res Treat. 2010. 841797]
7.
go back to reference Klein I, Iung B, Wolff M, Brochet E, Longuet P, Laissy JP, Duval X (2007) Silent T2* cerebral microbleeds: a potential new imaging clue in infective endocarditis. Neurology 68(23):2043PubMedCrossRef Klein I, Iung B, Wolff M, Brochet E, Longuet P, Laissy JP, Duval X (2007) Silent T2* cerebral microbleeds: a potential new imaging clue in infective endocarditis. Neurology 68(23):2043PubMedCrossRef
8.
go back to reference Subramaniam S, Puetz V, Dzialowski I, Barber PA (2007) Cerebral microhemorrhages in a patient with mycotic aneurysm. Revelance of T2-GRE imaging in SBE. Neurology 67(9):1697CrossRef Subramaniam S, Puetz V, Dzialowski I, Barber PA (2007) Cerebral microhemorrhages in a patient with mycotic aneurysm. Revelance of T2-GRE imaging in SBE. Neurology 67(9):1697CrossRef
9.
go back to reference Thiene G, Basso C (2006) Pathology and pathogenesis of infective endocarditis in native heart valves. Cardiovasc Pathol 15(5):256–263PubMedCrossRef Thiene G, Basso C (2006) Pathology and pathogenesis of infective endocarditis in native heart valves. Cardiovasc Pathol 15(5):256–263PubMedCrossRef
10.
go back to reference Bhuva P, Kuo SH, Claude Hemphill J, Lopez GA (2010) Intracranial hemorrhage following thrombolytic use for stroke caused by infective endocarditis. Neurocrit Care 12(1):79–82PubMedCrossRef Bhuva P, Kuo SH, Claude Hemphill J, Lopez GA (2010) Intracranial hemorrhage following thrombolytic use for stroke caused by infective endocarditis. Neurocrit Care 12(1):79–82PubMedCrossRef
11.
go back to reference Hart RG, Kagan-Hallet K, Joerns SE (1987) Mechanisms of intracranial hemorrhage in infective endocarditis. Stroke 18(6):1048–1056PubMedCrossRef Hart RG, Kagan-Hallet K, Joerns SE (1987) Mechanisms of intracranial hemorrhage in infective endocarditis. Stroke 18(6):1048–1056PubMedCrossRef
12.
go back to reference Masuda J, Yutani C, Waki R, Ogata J, Kuriyama Y, Yamaguchi T (1992) Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis. Stroke 23(6):843–850PubMedCrossRef Masuda J, Yutani C, Waki R, Ogata J, Kuriyama Y, Yamaguchi T (1992) Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis. Stroke 23(6):843–850PubMedCrossRef
Metadata
Title
Thrombolysis for stroke caused by infective endocarditis: an illustrative case and review of the literature
Authors
Elodie Ong
Laura Mechtouff
Emilien Bernard
Tae-Hee Cho
Lansana Laho Diallo
Norbert Nighoghossian
Laurent Derex
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Journal of Neurology / Issue 5/2013
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-012-6802-1

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