Document Detail


Cerebral Microbleeds Predict Impending Intracranial Hemorrhage in Infective Endocarditis.
MedLine Citation:
PMID:  22057098     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Cerebral microbleeds (CMBs) detected by T2*-weighted MRI are a potential indicator of hypertension, microvascular disease and hemorrhagic stroke. An association between infective endocarditis (IE) and CMBs has been reported recently, but the clinical significance remains unclear. We hypothesized that CMBs in patients with IE are associated with vascular vulnerabilities such as mycotic aneurysm or pyogenic vasculitis. Methods: We retrospectively reviewed 26 consecutive patients with definite IE who underwent T2*-weighted MRI and were admitted to 2 medical centers in Osaka, Japan, between January 2006 and June 2010. We examined the incidence of symptomatic intracranial hemorrhage (ICH) occurring after initial MRI examination and investigated the association between ICH, CMBs and other clinical characteristics. Results: CMBs were identified in 14 patients (54%), and 72% of CMBs were found in the lobar region. Symptomatic ICH was observed in 8 patients (31%) during the 3-month follow-up period after initial MRI examination. In multiple logistic regression analyses, the presence of preceding ICH [odds ratio (OR) 40.0, 95% confidence interval (CI) 2.5-2,870] and the presence of CMBs (OR 34.0, 95% CI 1.3-17,300) were independent predictors of the development of ICH. Using cutoff values for CMBs of ≥2 and ≥3, the adjusted ORs for ICH increased (OR 42.1, 95% CI 1.9-24,300, and OR 70.1, 95% CI 2.5-105,000, respectively). Conclusions: In addition to prior ICH, the presence of CMBs was a strong predictor of impending ICH in patients with IE. CMBs might represent vascular vulnerability related to IE.
Authors:
Shuhei Okazaki; Manabu Sakaguchi; Boohan Hyun; Keiko Nagano; Masafumi Tagaya; Yasushi Sakata; Taichi Sakaguchi; Kazuo Kitagawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-01
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  32     ISSN:  1421-9786     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  483-488     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
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