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  • Title: [Cardiac cerebral embolism].
    Author: Berlit P.
    Journal: Nervenarzt; 1983 Aug; 54(8):389-99. PubMed ID: 6621748.
    Abstract:
    135 cases of cardiogenic emboli to the brain are reported in view of symptoms, diagnosis, prognosis and therapy. Brain embolism occurred most often in ischemic heart disease with atrial fibrillation, followed by valvular heart disease, myocardial infarction and carditis. Usually there was a sudden onset of neurological symptoms during the morning hours. Initial lapses of consciousness were a bad prognostic sign--they appeared as well as seizures more often in embolic than in thrombotic brain infarctions. The clearly higher incidence of emboli to the left cerebral hemisphere has anatomical reasons. Angiographic findings depend on the time of examination; common are occlusions of the supraclinoid portion of the internal carotid artery, media-occlusions at the trifurcation, media-branch-occlusions and disturbed middle cerebral blood flow. CT and lumbar puncture do not support the diagnosis. Cardiologic examination should include X-ray of the chest, long time electrocardiogram and echocardiography. In view of a mortality of 22 per cent and major neurological residual symptoms in 34 percent the prognosis of brain embolism is serious. Early anticoagulant therapy in the absence of brain hemorrhage in CT seems to improve the prognosis by preventing reembolization.
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