Cerebral hemorrhage after mitral valve replacement in a patient with active infective endocarditis during the acute phase of a cerebellar infarction: a case report.

A 60-year-old woman presented with a high fever (39°C or higher). Transthoracic echocardiography revealed a large and mobile vegetation on the anterior mitral leaflet with moderate mitral regurgitation. Computed tomography revealed a cerebellar infarction. The large vegetation had extended into the mitral annulus and had become mobile, and furthermore the patient failed with cardiac decompensation. Although the cerebellar infarction was still in the acute phase, we performed a radical resection of the vegetation and infected tissue, annular reconstruction with an autologous pericardial patch, and mitral valve replacement 3 days after admission. After the operation, the patient suffered from subsequent cerebral hemorrhage in the occipital lobe. The patient received medical treatment and was discharged successfully without sequelae.