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Intracranial infectious aneurysms: a comprehensive review

Andrew F Ducruet1, Zachary L Hickman, Brad E Zacharia

  • 1Department of Neurological Surgery, Columbia University, 630 West 168th Street, New York, NY 10032, USA. afd12@columbia.edu

Neurosurgical Review
|October 20, 2009
PubMed

Insights

Mycotic aneurysms, rare infections of brain arteries, lack standard treatment. Combining data from 287 patients suggests antibiotics plus surgery or endovascular methods offer a viable management approach.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Intracranial infectious aneurysms (mycotic aneurysms) are rare cerebrovascular lesions.
  • Microbial infection of the cerebral arterial wall causes these aneurysms.
  • Lack of epidemiological data and varied presentations hinder standardized management.

Purpose of the Study:

  • To synthesize existing literature on mycotic aneurysms.
  • To estimate demographic and clinical characteristics.
  • To review current treatment paradigms.

Main Methods:

  • Comprehensive literature search of MEDLINE database (1950-2009).
  • Keywords: "infectious," "mycotic," "cerebral aneurysm," "intracranial aneurysm."
  • Analysis of 27 clinical series comprising 287 patients.

Main Results:

  • Synthesized data from 287 patients to characterize mycotic aneurysms.
  • Identified treatment approaches involving antibiotics and interventions.
  • Highlighted the need for further prospective studies.

Conclusions:

  • Antibiotic administration is supported alongside surgical or endovascular intervention.
  • Treatment choice depends on aneurysm characteristics, location, and patient status.
  • Mycotic aneurysms are life-threatening; further research is needed to define optimal outcomes.

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