摘要感染性心内膜炎(infective endocarditis,IE)的感染性赘生物脱落栓塞是引起脑卒中的病因之一.近年急性缺血性卒中机械取栓术在国内外广泛开展,但是国内通过回收血栓的病理检查确认卒中病因的报道较少见.现报道1例回收血栓病理确诊的IE所致急性脑梗死患者.患者为33岁男性,既往有扩张性心肌病病史,主因“突发左侧肢体麻木力弱14h”就诊,行机械取栓术,回收血栓病理检查发现革兰阳性球菌.患者入院后出现高热、脓毒性休克、急性肾衰竭,超声心动图显示左心室附壁血栓,因此确诊为IE所致急性脑梗死.

abstractsInfective endocarditis is one of the causes of cerebral infarction.Mechanical thrombectomy has been widely used in China for years.However,reports involving retrieved thrombus pathology are somewhat scarce.Here a case in which the cause of stroke was confirmed by thrombus pathology is reported.A 33-year male with a history of dilated cardiomyopathy visited the emergency because of sudden onset of left-sided weakness for 14 hours.Mechanical thrombectomy was performed,and the pathological study of the retrieved thrombus demonstrated Gram-staining positive cocci.The patient was combined with fever,septic shock,and acute kidney injury.Ultrasoundcardiography showed vegetation in the left ventricle.Therefore,he was definitely diagnosed as acute ischemic stroke due to infective vegetation embolism.