Acute Development and Rupture of a Basilar Tip Mycotic Aneurysm

Area of Science:

• Neurology
• Vascular Surgery
• Infectious Diseases

Background:

• Infectious intracranial aneurysms (IIAs) are rare but clinically significant vascular lesions.
• The precise timeline for the development and growth of IIAs remains largely undefined.
• Existing literature primarily consists of case series and retrospective studies, limiting detailed understanding of IIA formation.

Purpose of the Study:

• To present a case illustrating the acute development and rupture of an infectious intracranial aneurysm.
• To provide insights into the potential time frame for mycotic aneurysm growth.

Main Methods:

• A case report detailing a patient with endocarditis and initial diagnosis of a distal middle cerebral artery aneurysm.
• Documentation of the patient's clinical course, including a subsequent subarachnoid hemorrhage 5 days after initial diagnosis.
• Description of the development and treatment of a new basilar tip aneurysm.

Main Results:

• A patient developed a new infectious intracranial aneurysm and experienced its rupture within a 5-day period.
• The patient was undergoing treatment for endocarditis and an initial aneurysm during this time.
• The newly identified basilar tip aneurysm was successfully treated with coil embolization.

Conclusions:

• This case demonstrates that infectious intracranial aneurysms can form and rupture acutely, within days.
• The findings underscore the potential for rapid progression and associated neurological sequelae in patients with IIAs.
• Understanding the acute nature of IIA development is crucial for timely diagnosis and management.