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Infectious aneurysm clipping by an MRI/MRA wand-guided protocol. A case report and technical note

A Harris1, E Levy, E Kanal

  • 1Department of Neurosurgery, University of Pittsburgh, Lothrop Street, Pittsburgh, PA 15213-2582, USA. aharris@neuronet.pitt.edu

Pediatric Neurosurgery
|September 11, 2001
PubMed

Insights

This study highlights a novel MRI protocol for precisely locating distal mycotic aneurysms, often associated with subacute bacterial endocarditis. This technique aids surgical excision, improving outcomes for patients with infectious intracranial aneurysms.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Surgery

Background:

  • Infectious aneurysms, often linked to subacute bacterial endocarditis (SBE), pose significant mortality risks.
  • Distal locations and friability complicate surgical management of these aneurysms.
  • Intracranial hemorrhage (ICH) can further obscure these challenging lesions.

Observation:

  • A 9-year-old boy with SBE experienced intracranial hemorrhage due to a mycotic aneurysm.
  • A specialized MRI protocol precisely localized the distal mycotic aneurysm.
  • The aneurysm was successfully excised following accurate localization.

Findings:

  • MRI/MRA-guided frameless stereotaxy offers millimeter-level precision for localizing distal mycotic aneurysms.
  • This advanced imaging approach facilitates technically difficult aneurysm excision.
  • The described MRI protocol can be a valuable tool in managing complex infectious aneurysms.

Implications:

  • Improved localization of distal mycotic aneurysms can significantly decrease surgical risks.
  • This technique has the potential to reduce morbidity and mortality associated with infectious aneurysms.
  • Frameless stereotaxy guided by MRI/MRA may enhance patient outcomes in neurovascular surgery.

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