Infective endocarditis.

Bacterial endocarditis can cause septic emboli in the brain, leading to

ischaemic stroke. In addition to the increased risk of stroke, bacterial endocarditis presents
difficulties for stroke treatment as it is associated with an increased risk of haemorrhagic.
transformation after thrombolysis owing to septic arteritis that weakens vessel walls41. Surveillance
for mycotic aneurysms (infected aneurysms) should be considered, as they can occur after
endocarditis and can rupture, causing subarachnoid or intracerebral haemorrhage

Hypokinetic segment with mural thrombus. Regions of segmental hypokinesis within the heart can
occur following myocardial infarction, which can predispose to cardioembolic stroke. In these cases,
the hypokinesis can allow the formation of mural thrombi (that is, thrombi attached to the wall of a
vessel or the heart) that can embolize and cause ischaemic stroke42. Severely reduced ejection
fraction (the percentage of blood pumped from the ventricles each time the heart contracts) in
individuals with dilated cardiomyopathy is also a risk for cardioembolic ischaemic stroke, as is the
rare Takotsubo cardiomyopathy due to sympathetic overload4

Haematological disorders. Haematological disorders are a rare but important cause of ischaemic
stroke44. They are a more common cause of clotting in the cerebral veins, termed cerebral venous
thrombosis. Essential thrombocytosis (via increased platelet count), polycythaemia vera (via
increased red blood cell count and blood viscosity) and antiphospholipid syndrome (via a
procoagulant state) are three of the more common haematological conditions that predispose to
thrombus formation. Stroke can be the presenting feature of these disorders (Table 1). In addition,
sickle cell anaemia can cause stroke45 and is an important cause of paediatric stroke in individuals of
African descent.