Cerebral Microbleeds Are Frequent in Infective Endocarditis: A Case–Control Study

BACKGROUND AND PURPOSE—Cerebral microbleeds (CMBs) have been described using MRI in patients with cardiovascular risk factors or prior stroke and could be an indicator of small vessel disease. CMBs have been reported in isolated cases of infective endocarditis (IE), but their frequency and the assoc...

Full description

Saved in:
Bibliographic Details
Published in:Stroke (1970) 2009-11, Vol.40 (11), p.3461-3465
Main Authors: Klein, Isabelle, Iung, Bernard, Labreuche, Julien, Hess, Agathe, Wolff, Michel, Messika-Zeitoun, David, Lavallée, Philippa, Laissy, Jean-Pierre, Leport, Catherine, Duval, Xavier
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Case-Control Studies
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - diagnosis
Endocarditis - complications
Endocarditis - diagnosis
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Male
Medical sciences
Microcirculation
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Prospective Studies
Retrospective Studies
Vascular diseases and vascular malformations of the nervous system
Young Adult
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND AND PURPOSE—Cerebral microbleeds (CMBs) have been described using MRI in patients with cardiovascular risk factors or prior stroke and could be an indicator of small vessel disease. CMBs have been reported in isolated cases of infective endocarditis (IE), but their frequency and the association of CMBs with IE have not yet been studied. METHODS—A case–control imaging study in a referral institutional tertiary care center was conducted. Systematic brain MRIs, including T2*-weighted sequences, were performed in 60 patients with IE within 7 days of hospital admission and in 120 age- and gender-matched control subjects without IE. Two neuroradiologists, who were blinded to patient characteristics, independently assessed the presence, location, and size of CMBs using a standardized form. RESULTS—The interobserver agreement level on the presence of CMBs was high with a κ coefficient range (95% CI) of 0.70 (0.42 to 0.98) for subcortical regions to 0.91 (0.82 to 0.99) for cortical areas. CMBs were more prevalent in patients with IE (57% [n=34]) than in control subjects (15% [n=18]; matched OR, 10.06; 95% CI, 3.88 to 26.07). Moreover, the OR of IE increased gradually with CMBs number with an OR of 6.12 (95% CI, 2.09 to 17.94) for one to 3 CMBs and of 20.12 (95% CI, 5.20 to 77.80) for >3 CMBs. CONCLUSION—CMBs are highly frequent in patients with IE. The strong association found between IE and CMBs supports the need for further evaluation of CMBs as additional diagnostic criteria of IE.
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.109.562546