Dual-Peak Post-Stroke Edema in a Patient with Infective Endocarditis

Introduction Cerebral edema following ischemic stroke due to infective endocarditis classically peaks between 3 and 5 days. Case Presentation The authors describe the case of a 23yearold man with infective endocarditis complicated by ischemic stroke who developed cerebral edema that peaked at 8 days and 15 days poststroke and subsequently resolved without neurosurgical intervention. To the best of the authors’ knowledge, there is no reported case of dual peaks in edema occurring in a stroke patient with infective endocarditis. Discussion Recognition of dualpeak edema as a phenomenon in infective endocarditisrelated stroke is essential to guide neurosurgical intervention and may be important for determining optimal timing of cardiac valvereplacement surgery. Conclusion Further investigations are necessary to understand the frequency of such occurrences in patients with ischemia related to infective endocarditis. Introduction I nfective endocarditis (IE) is a rare disease, with a reported annual incidence of 10,000– 15,000 cases per year in the United States.1 The inhospital mortality rate for IE has remained stable at 20% despite improvements in antibiotics and cardiac surgery.1,2 An estimated 24– 40% of IE cases are associated with symptomatic neurological complications, with ischemic stroke being the most common neurological complication. In fact, a cerebrovascular event is often the presenting symptom for patients with IE.3,4 Ischemic insults in IE patients can lead to edema and mass effect, which complicate the decision for valve replacement.4

• Publication year

  2019

• Venue

  Michigan Journal of Medicine

• Publication date

  2019-05-20

• Fields of study

  Medicine

• Identifiers
  DOI 10.3998/MJM.13761231.0004.107
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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