We note the important thickness of the septal wall at 26mm, (arrow) the reduction of caliber of the LV and the hunting chamber (star) with dilatation of left atrium (arrow head)
The patient was operated on day 3 of his admission with mitral valve replacement + septal myomectomy
Then he was put on an intravenous antibiotic treatment (imipenem, teicoplanin and gentamicin)
The evolution was marked by an improvement with apyrexia, regression of the biological inflammatory syndrome and disappearance of the sub-aortic gradient and mitral insufficiency.
During the follow-up :
7 days after the operation, the patient presented a convulsive seizures.
A cerebral CT scan was performed, it showed a cerebral hematoma with quadri ventricular flooding, sub arachnoid hemorrhage and a diffuse cerebral edema responsible for cerebral herniation; sub falcoriel, central, temporal (figure 6).