Related Experiment Video
Updated: Apr 16, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Infectious endocarditis complicated with preoperative infectious intracranial aneurysm;report of a case]
Masahiko Ezure1, Tatsuo Kaneko, Yutaka Hasegawa
1Division of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
Abstract:
A 44-year-old man was admitted with the diagnosis of active infective endocarditis( IE) due to Streptococcus mitis, complicated with infectious intracranial aneurysm. Preoperative echocardiography showed mobile vegetation on the mitral leaflet, size of which was 20 mm. The magnetic resonance imaging( MRI) demonstrated that the size of aneurysm was increasing, and infectious intracranial aneurysm was treated surgically. Twenty one days after the operation, the mitral valve plasty was performed. He was discharged on foot without any neurological findings. The duration between the brain surgery and the cardiac surgery was thought to be important to prevent the new neurological complication.
Insights
A patient with Streptococcus mitis infective endocarditis (IE) and an intracranial aneurysm underwent successful surgical treatment. The timing between brain and cardiac surgery was crucial for preventing further neurological complications.
Area of Science:
- Cardiology
- Neurosurgery
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a serious infection that can lead to severe complications, including septic emboli to the brain.
- Infectious intracranial aneurysms are rare but life-threatening complications of IE.
Observation:
- A 44-year-old male presented with active IE caused by Streptococcus mitis, complicated by an enlarging infectious intracranial aneurysm.
- Echocardiography revealed a 20 mm mobile vegetation on the mitral valve.
- MRI confirmed the growing aneurysm, necessitating urgent surgical intervention.
Findings:
- The patient underwent successful surgical treatment for the infectious intracranial aneurysm.
- Mitral valve plasty was performed 21 days post-neurosurgery.
- The patient was discharged neurologically intact.
Implications:
- A staged surgical approach, with a significant interval between neurosurgery and cardiac surgery, may be critical in preventing new neurological events.
- This case highlights the complex management of IE with concurrent intracranial aneurysms.
- Optimal timing of interventions is key to improving outcomes in patients with combined cardiovascular and neurological septic complications.
