Emergency valve surgery for infective endocarditis complicated by acute intracranial hemorrhage: A case report

IntroductionOptimal timing of surgical treatment for infective endocarditis (IE) complicated by intracranial hemorrhage remains controversial.Presentation of caseA 43-year-old man with IE received appropriate antibiotic therapy but had recurrence of cerebral infarction and intracranial hemorrhage (ICH). Emergency valve surgery was performed 2 days after ICH onset because of heart failure and recurrence of cerebral complications. Postoperatively, he showed no neurologic symptoms; neuroimaging showed no enlargement of ICH.DiscussionPostoperative risk of neurologic deterioration may be relatively lower than previously thought in patients with IE who undergo surgery within 1 month after ICH onset.ConclusionsEmergency surgery in patients with ICH is justified in cases of multiple indications for such small ICH. Further evaluation regarding the risk of subsequent hemorrhage in patients with ICH who require emergency valve surgery is warranted.