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Infectious intracranial aneurysms.

C E Clare1, D L Barrow

  • 1Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.

Neurosurgery Clinics of North America
|July 1, 1992
PubMed
Summary
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Infectious cerebral aneurysms, though rare, pose a high mortality risk, often diagnosed after hemorrhage. Early detection and treatment, including antibiotics or surgery, are crucial for better outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Infectious cerebral aneurysms are rare, comprising 2.6%–6% of all intracranial aneurysms.
  • They originate from intravascular (e.g., bacterial endocarditis) or extravascular infection sources.
  • Fungal infectious aneurysms are increasing and carry a worse prognosis.

Purpose of the Study:

  • To highlight the importance of early diagnosis and management of infectious cerebral aneurysms.
  • To review the etiology, presentation, and treatment strategies for these uncommon vascular lesions.

Main Methods:

  • Review of autopsy studies and clinical case series on infectious cerebral aneurysms.
  • Analysis of etiological factors, particularly bacterial endocarditis and fungal infections.

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  • Evaluation of diagnostic challenges and treatment outcomes.

    • Main Results:

    • High mortality rates (60%–90%) associated with infectious cerebral aneurysms, typically discovered post-hemorrhage.
    • Bacterial endocarditis is the most common cause, leading to embolization.
    • Fungal aneurysms present a graver prognosis.

    Conclusions:

    • A high index of suspicion is vital for early diagnosis before rupture.
    • Treatment may involve antibiotics alone or necessitate surgical intervention.
    • Prompt diagnosis and management significantly impact patient morbidity and mortality.