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Silent Strike: Stroke in Context of Endocarditis – Brain Imaging as a Catalyst for Diagnosis

Iulia-Cosmina Stoican

Iulia-Cosmina Stoican

Neurology Department, National Institute of Neurology and Neurovascular DiseasesBucharest, Romania
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Stoican, Iulia-Cosmina
, 
Dorin Dragoș

Dorin Dragoș

  • Internal Medicine Department, University Emergency HospitalBucharest, Romania
  • ”Carol Davila” University of Medicine and PharmacyBucharest, Romania
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Dragoș, Dorin
, 
Atena Papagheorghe

Atena Papagheorghe

Neurosurgery Department, University Emergency HospitalBucharest, Romania
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Papagheorghe, Atena
, 
Suzana Maria Guberna

Suzana Maria Guberna

  • ”Carol Davila” University of Medicine and PharmacyBucharest, Romania
  • Cardiology Department, Prof. Dr. Bagdasar-Arseni, Emergency Clinical HospitalBucharest, Romania
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Guberna, Suzana Maria
, 
Sorin Tuta

Sorin Tuta

  • Neurology Department, National Institute of Neurology and Neurovascular DiseasesBucharest, Romania
  • ”Carol Davila” University of Medicine and PharmacyBucharest, Romania
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Tuta, Sorin
 e 
Maria Mirabela Manea

Maria Mirabela Manea

  • Neurology Department, National Institute of Neurology and Neurovascular DiseasesBucharest, Romania
  • ”Carol Davila” University of Medicine and PharmacyBucharest, Romania
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Manea, Maria Mirabela
  
27 feb 2025
Silent Strike: Stroke in Context of Endocarditis – Brain Imaging as a Catalyst for Diagnosis's Cover Image
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Categoria dell'articolo: Original Articles
Pubblicato online: 27 feb 2025
Pagine: 145 - 151
Ricevuto: 22 lug 2024
DOI: https://doi.org/10.2478/rjim-2025-0003
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© 2025 Iulia-Cosmina Stoican et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1.

The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of ASPECTS and pc-ASPECTS in predicting endocarditis-related stroke.
The area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of ASPECTS and pc-ASPECTS in predicting endocarditis-related stroke.

Clinical outcomes of the two groups (p value = 4×10−13 – as calculated by Fisher’s exact test)

Clinical outcome Study group (42 patients) Control group (42 patients)
Improved 12 42
Worsened 14 0
Deceased 16 0

Baseline laboratory parameters for the two groups;

Laboratory parameter Study group Median value, (Q1-Q3) Control group Median value, (Q1-Q3) p-value
Serum creatinine level (mg/dL) 0.885 (0.71–1.165) 0.925 (0.7625–1.11) 0.71
Hemoglobin level (g/dL) 12.5 (10.03–13.55) 14 (12.3–14.875) 0.0064
Neutrophil count (*1000/uL) 9 (7–12.3) 6.78 (4.95–8.61) 0.00095
White blood cells count (*1000/uL) 11 (8.95–15) 9.26 (7.55–12.1775) 0.028
Platelet count (*1000/uL) 217 (153.65–260.75) 249.5 (195.25–291) 0.026
Erythrocyte sedimentation rate (mm/h) 37.5 (19.25–75.75) 20 (9.75–37.75) 0.009

Baseline characteristics of the two groups analyzed with Fisher’s exact test_

Characteristic Odds ratio (95% confidence interval) (a,b,c,d)
Male gender 0.91 (0.35–2.33) (20, 22, 21, 21)
Arterial hypertension 0.91 (0.35–2.33) (20, 22, 21, 21)
Type 2 diabetes 1 (0.34–2.97) (31, 11, 31, 11)
Dyslipidemia 0.41 (0.15–1.08) (20, 22, 29, 13)
Chronic kidney disease 1.57 (0.34–8.24) (38, 4, 36, 6)
Chronic heart failure 2.11 (0.7–6.7) (34, 8, 28, 14)
History of myocardial infarction 0.3 (0.03–1.84) (36, 6, 40, 2)
Concomitant neoplasm 2.09 (0.28–24.34) (40, 2, 38, 4)

The diagnostic performance of imaging findings on brain CT

Brain CT characteristic Sn Sp LR+ LR−
Hemorrhagic transformation 0.19 0.905 2 0.895
Multiple lesions 0.786 0.857 5.497 0.25
Multiple arterial territories 0.738 0.929 10.394 0.282
Watershed lesions 0.429 0.857 3 0.666
Lingua:
Inglese
Frequenza di pubblicazione:
4 volte all'anno
Argomenti della rivista:
Medicina, Medicina clinica, Medicina interna, Medicina interna, altro, Cardiologia, Gastroenterologia, Reumatologia
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