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Published on: January 7, 2019

Ruptured intracranial mycotic aneurysm in infective endocarditis: a natural history

Isabel Kuo1, Theodore Long, Nathan Nguyen

  • 1University of Southern California Keck School of Medicine, Los Angeles, CA 90089, USA.

Case Reports in Medicine
|October 2, 2010
PubMed

Insights

Mycotic aneurysms, rare brain artery bulges caused by infection, have high mortality if ruptured. This case highlights emergent treatment for a ruptured mycotic aneurysm in a patient with infective endocarditis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Mycotic aneurysms are uncommon intracranial aneurysms associated with infections like infective endocarditis.
  • Ruptured mycotic aneurysms have a high mortality rate.

Observation:

  • A 54-year-old male with mitral valve infective endocarditis and acute stroke developed subarachnoid hemorrhage.
  • CT Angiography revealed a large intracranial aneurysm, which rapidly progressed to intraparenchymal hemorrhage.

Findings:

  • The patient required emergency craniotomy and aneurysm clipping for the ruptured lesion.
  • Management guidelines for intracranial mycotic aneurysms are limited, often based on retrospective studies.

Implications:

  • This case underscores the critical, rapid progression of ruptured mycotic aneurysms.
  • Presents a patient's natural history and reviews current management strategies for these rare vascular lesions.

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