Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis
A 59-year-old woman visited a local hospital for fever and was diagnosed as having infective endocarditis (IE) on the basis of blood cultures and transthoracic echocardiography. Based on clinical episodes of subarachnoid hemorrhage after admission, it was judged that she was not a good candidate for...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2014/158041 |
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| author | Chikahiko Koeda Atsushi Tashiro Tomohiro Takahashi Masanobu Niiyama Ryohei Sakamoto Takumi Kimura Yoshihiro Morino Katsutoshi Terui Ryoichi Tanaka Kunihiro Yoshioka Hajime Kin Hitoshi Okabayashi Motoyuki Nakamura |
| author_facet | Chikahiko Koeda Atsushi Tashiro Tomohiro Takahashi Masanobu Niiyama Ryohei Sakamoto Takumi Kimura Yoshihiro Morino Katsutoshi Terui Ryoichi Tanaka Kunihiro Yoshioka Hajime Kin Hitoshi Okabayashi Motoyuki Nakamura |
| author_sort | Chikahiko Koeda |
| collection | DOAJ |
| description | A 59-year-old woman visited a local hospital for fever and was diagnosed as having infective endocarditis (IE) on the basis of blood cultures and transthoracic echocardiography. Based on clinical episodes of subarachnoid hemorrhage after admission, it was judged that she was not a good candidate for urgent open heart surgery, and it was decided to treat her with conservative medical therapy for the acute phase. We explored the optimum timing for surgery by employing gadolinium (Gd) contrast medium-enhanced magnetic resonance imaging (MRI) T2* weighted image (black dots) due to her high risk of perioperative cerebral hemorrhage. After the disappearance of the contrast media enhancement effect around the black dots, open heart surgery was performed successfully on the 103rd hospitalization day. The patient was discharged 22 days after the surgery with no clinical complications. This case suggests that disappearance of the contrast media enhancement effect around the black dots may be a useful marker for optimal timing of surgery to minimize the risk of perioperative cerebral hemorrhage in patients with IE. Learning Objective. The MRI T2* weighted images including those with Gd contrast medium enhancement effect may be useful for evaluating the risk of perioperative intracranial hemorrhage in IE. |
| format | Article |
| id | doaj-art-5fc8205151c445b3a72eb2d851ed9d5e |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-5fc8205151c445b3a72eb2d851ed9d5e2025-02-03T06:08:11ZengWileyCase Reports in Cardiology2090-64042090-64122014-01-01201410.1155/2014/158041158041Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective EndocarditisChikahiko Koeda0Atsushi Tashiro1Tomohiro Takahashi2Masanobu Niiyama3Ryohei Sakamoto4Takumi Kimura5Yoshihiro Morino6Katsutoshi Terui7Ryoichi Tanaka8Kunihiro Yoshioka9Hajime Kin10Hitoshi Okabayashi11Motoyuki Nakamura12Division of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Emergency, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Cardiovascular Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Cardiovascular Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDivision of Cardioangiology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanA 59-year-old woman visited a local hospital for fever and was diagnosed as having infective endocarditis (IE) on the basis of blood cultures and transthoracic echocardiography. Based on clinical episodes of subarachnoid hemorrhage after admission, it was judged that she was not a good candidate for urgent open heart surgery, and it was decided to treat her with conservative medical therapy for the acute phase. We explored the optimum timing for surgery by employing gadolinium (Gd) contrast medium-enhanced magnetic resonance imaging (MRI) T2* weighted image (black dots) due to her high risk of perioperative cerebral hemorrhage. After the disappearance of the contrast media enhancement effect around the black dots, open heart surgery was performed successfully on the 103rd hospitalization day. The patient was discharged 22 days after the surgery with no clinical complications. This case suggests that disappearance of the contrast media enhancement effect around the black dots may be a useful marker for optimal timing of surgery to minimize the risk of perioperative cerebral hemorrhage in patients with IE. Learning Objective. The MRI T2* weighted images including those with Gd contrast medium enhancement effect may be useful for evaluating the risk of perioperative intracranial hemorrhage in IE.http://dx.doi.org/10.1155/2014/158041 |
| spellingShingle | Chikahiko Koeda Atsushi Tashiro Tomohiro Takahashi Masanobu Niiyama Ryohei Sakamoto Takumi Kimura Yoshihiro Morino Katsutoshi Terui Ryoichi Tanaka Kunihiro Yoshioka Hajime Kin Hitoshi Okabayashi Motoyuki Nakamura Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis Case Reports in Cardiology |
| title | Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis |
| title_full | Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis |
| title_fullStr | Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis |
| title_full_unstemmed | Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis |
| title_short | Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis |
| title_sort | possible usefulness of gadolinium enhanced brain mri for evaluating risk of perioperative hemorrhage a case of infective endocarditis |
| url | http://dx.doi.org/10.1155/2014/158041 |
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