Neurologic Manifestations of Infective Endocarditis

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Abstract
NEUROLOGIC complications of infective endocarditis (IE) most commonly occur as a result of embolization from endocardial vegetation, with resultant occlusion of cerebral arteries.1-5 An ischemic or hemorrhagic stroke or a transient ischemic attack (TIA) can then develop. Dissemination of infected embolic material into cerebral or meningeal vessels may also lead to meningitis or brain abscesses.1,3-6 More nonspecific neurologic manifestations associated with IE include headache, seizures, and toxic encephalopathy.1-5 Cerebral hemorrhage is the most dramatic, though fortunately rare, neurologic complication of IE. It can be caused by a rupture of a mycotic aneurysm even months to years after the IE has been cured.7,8 Clinicians should be aware of the wide variety of cerebral presentations in patients with IE, since these complications may constitute the first symptoms of the disease, thus provoking the suspicion of endocarditis.