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Management of consecutive development of ruptured intracranial mycotic aneurysms: case report

Ke Wang1, Jiping Sun, Xiang Zhang

  • 1Tongji University, Shanghai Tenth People's Hospital, Neurosurgical Department, Shanghai, China.

Turkish Neurosurgery
|May 28, 2015
PubMed

Insights

Intracranial mycotic aneurysms (MAs) are rare but dangerous. This case shows MAs can recur even after treating infective endocarditis and cardiac surgery, necessitating ongoing monitoring.

Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Intracranial mycotic aneurysms (MAs), or infectious aneurysms, are rare vascular lesions with high morbidity and mortality.
  • Ruptured MAs carry an 80% mortality rate, while unruptured MAs have a 30% mortality rate.

Observation:

  • A 22-year-old male presented with two consecutive ruptured intracranial MAs.
  • The MAs were linked to infective endocarditis, occurring seven months apart.
  • The second MA developed and ruptured despite prolonged antibiotic treatment and aortic valve replacement surgery.

Findings:

  • Intracranial mycotic aneurysms can recur even after successful management of the underlying infective endocarditis and cardiac repair.
  • The formation and rupture of a second MA highlight the persistent risk associated with this condition.

Implications:

  • Patients with a history of intracranial MAs require vigilant, long-term angiographic surveillance, even after seemingly curative interventions.
  • This case underscores the complex management of MAs and suggests current treatment paradigms may need re-evaluation for persistent risks.

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