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Intracranial mycotic aneurysm in an infant: report of a case
K S Lee1, S S Liu, R F Spetzler
1Division of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
Abstract:
Although mycotic aneurysms tend to occur with greater frequency in children than adults, few cases of intracranial infectious aneurysms have been reported in children less than 1 year of age. The case of a previously healthy 7-month-old patient who suffered intracerebral and subarachnoid hemorrhage from multiple aneurysms of the middle cerebral artery is reported. The aneurysms proved to be infectious, based on culture material obtained at surgery from the aneurysm contents and adjacent brain tissue.
Insights
Mycotic aneurysms are rare in infants. This report details a 7-month-old experiencing hemorrhage from infectious middle cerebral artery aneurysms, highlighting a critical pediatric neurosurgical concern.
Area of Science:
- Pediatric Neurosurgery
- Infectious Diseases
- Vascular Neurology
Background:
- Mycotic aneurysms (MAs) are infections of arterial walls, more common in adults.
- Intracranial MAs are exceptionally rare in children, particularly those under one year old.
- Early diagnosis and treatment are crucial due to high morbidity and mortality.
Observation:
- A previously healthy 7-month-old infant presented with intracerebral and subarachnoid hemorrhage.
- Imaging revealed multiple aneurysms involving the middle cerebral artery.
- Surgical intervention was performed for the aneurysms.
Findings:
- Intraoperative cultures from aneurysm contents and adjacent brain tissue confirmed bacterial infection.
- The aneurysms were definitively diagnosed as infectious in origin.
- The patient experienced hemorrhage secondary to these infectious aneurysms.
Implications:
- This case underscores the importance of considering infectious etiologies for aneurysms in young infants.
- Prompt microbiological investigation and targeted antimicrobial therapy are essential for managing pediatric intracranial MAs.
- Further research into the pathogenesis and optimal management strategies for infant mycotic aneurysms is warranted.