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Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling
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Staphylococcus endocarditis associated with infectious vasculitis and recurrent cerebral hemorrhages
Diederik van de Beek1, Alejandro A Rabinstein, Steve G Peters
1Division of Critical Care Neurology, Department of Neurology, Mayo Clinic College of Medicine, W8B, 200 First Street SW, Rochester, MN 55905, USA.
Neurocritical Care
|September 21, 2007
Summary
Endovascular coiling offers an advantage for treating infectious intracranial aneurysms complicating endocarditis. However, it may not fully prevent future hemorrhages from new aneurysm ruptures, especially with associated vasculitis.
Area of Science:
- Neurology
- Cardiology
- Interventional Radiology
Background:
- Infectious endocarditis often necessitates urgent valve surgery, posing challenges for patients with intracranial aneurysms and hemorrhage.
- Endovascular treatment presents a potential therapeutic advantage for infectious intracranial aneurysms.
Observation:
- A case of ruptured infectious intracranial aneurysm with hemorrhage following endocarditis and successful coil occlusion is presented.
- A literature review identified 34 adult cases of endovascular treatment for infectious aneurysms, all initially presenting with hemorrhage.
Findings:
- The reported mortality rate for endovascular treatment was low (6%), with 37% experiencing neurologic disability.
- One patient experienced rehemorrhage after treatment due to a new aneurysm rupture.
- The presented case showed generalized cerebral infectious vasculitis on CT scan.
Implications:
- Endovascular coiling is a valuable treatment for infectious intracranial aneurysms.
- Complete prevention of hemorrhage from new aneurysm ruptures, particularly in cases of panvasculitis, cannot be guaranteed with endovascular coiling.
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