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Management of intracranial infectious aneurysms: a series of 16 cases

Loi K Phuong1, Michael Link, Eelco Wijdicks

  • 1Department of Neurosurgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Neurosurgery
|October 18, 2002
PubMed
Abstract

Insights

Management of intracranial infectious aneurysms can be improved. Ruptured aneurysms require surgery, while unruptured ones benefit from observation and antibiotic therapy, with surgery considered if enlargement occurs.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Intracranial infectious aneurysms (IIAs) are rare but serious vascular lesions.
  • Optimal management strategies for IIAs remain debated.

Observation:

  • A retrospective review of 16 patients with IIAs was conducted.
  • The mean follow-up period was 86 months.

Findings:

  • No rehemorrhage occurred during antibiotic treatment.
  • Mortality and long-term outcomes for ruptured IIAs may be better than previously assumed.
  • No significant difference in outcomes was observed between single vs. multiple aneurysms or between surgical resection and antibiotic-only treatment.

Implications:

  • Ruptured IIAs warrant operative intervention.
  • Unruptured IIAs can be managed with observation and antibiotics, with angiography for follow-up.
  • Surgical resection for unruptured IIAs should be considered if the aneurysm grows and the patient can tolerate anesthesia.

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