Archives des maladies du coeur et des vaisseaux
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Thirty out of 287 patients (10.4%) admitted to hospital for infective endocarditis between December 1970 and January 1990 had neurological complications. Twenty-three patients had native valve infectious endocarditis and 7 had prosthetic valve endocarditis. The clinical features were characterized by the frequency of aortic valve involvement (23 out of 30) and other complications, especially cardiac failure (16 cases) and peripheral vascular manifestations (7 cases). ⋯ Four patients underwent neurosurgery: 3 for clipping a mycotic aneurysm and 1 for drainage of an intracerebral haematoma. Poor prognostic factors were: coma, cardiac failure, cardiac valve prosthesis and, above all, the extent and multiplicity of the neurological lesions. The authors propose the following measures to improve the prognosis: early surgery in cases of large and/or mobile vegetations especially when the infecting organism is a staphylococcus and when a systemic embolism has occurred; routine CT scanning and/or digitised cerebral angiography in all patients with infective endocarditis to detect surgically accessible mycotic aneurysms.
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Arch Mal Coeur Vaiss · Jan 1991
Review[The role of the endothelium in the regulation of vasomotor activity].
The classical physiological concept of the endothelium was that of a barrier and a surface of exchange. Little importance was attached to its role in the regulation of vascular tone. ⋯ These different factors and their possible roles in vascular pathology are reviewed. The endothelial function or functions are probably abnormal in many pathological situations.