IMAGING OF THE NEUROLOGICAL COMPLICATIONS OF INFECTIVE ENDOCARDITIS

We describe the findings on CT or MRI in five patients with neurologic al symptoms and underlying infective endocarditis (IE). We noted the s ize, number, and distribution of lesions, the presence or absence of h aemorrhage, and contrast enhancement patterns. The number of lesions r anged from 4 to more than 10 in each patient, Their size varied from p unctate to 6 cm; they were distributed throughout the brain, The lesio ns could be categorized into four patterns based on imaging features. A cortical infarct pattern was seen in all patients. Patchy lesions, w hich did not enhance, were found in the white matter or basal ganglia in three. Isolated, tiny, nodular or ring-enhancing white matter lesio ns were seen in three patients, and parenchymal haemorrhages in four. In addition to the occurrence of multiple lesions with various pattern s in the same patient, isolated, tiny, enhancing lesions in the white matter seemed to be valuable features which could help to differentiat e the neurological complications of IE from other thromboembolic infar cts.