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Examination of Host Phenotypes in Gambusia affinis Following Antibiotic Treatment
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Examination of Host Phenotypes in Gambusia affinis Following Antibiotic Treatment

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Clinical course of infectious intracranial aneurysm undergoing antibiotic treatment

Cory J Rice1, Sung-Min Cho2, Robert J Marquardt1

  • 1Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Journal of the Neurological Sciences
|June 21, 2019
PubMed
Abstract

Insights

Infectious intracranial aneurysms (IIAs) are dynamic, with only a quarter resolving with antibiotics alone. Longer antibiotic treatment before IIA discovery correlates with better outcomes, while saccular morphology may predict unfavorable results.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Infectious intracranial aneurysm (IIA), also known as mycotic aneurysm, is a serious cerebrovascular complication stemming from infective endocarditis.
  • Understanding the clinical trajectory of IIAs during antibiotic therapy is crucial for patient management.

Purpose of the Study:

  • To describe the clinical course and outcomes of infectious intracranial aneurysms (IIAs) in patients undergoing antibiotic treatment.
  • To identify factors associated with favorable or unfavorable outcomes in IIAs.

Main Methods:

  • Retrospective review of medical records for patients with infective endocarditis and cerebral angiography between 2011 and 2016.
  • Follow-up angiography was used to assess aneurysm outcomes (growth, rupture, resolution, regression) until intervention or resolution.

Main Results:

  • Of 618 patients, 40 (6.5%) had 43 IIAs. Twenty-five unruptured IIAs were followed for a median of 18 antibiotic days.
  • Unfavorable outcomes (rupture, growth, new formation) occurred in 44% of aneurysms, while 28% showed favorable outcomes (resolution, regression).
  • Saccular morphology was linked to unfavorable outcomes (p=0.013), and longer antibiotic exposure prior to IIA discovery was associated with favorable outcomes (p=0.046).

Conclusions:

  • Infectious intracranial aneurysms exhibit dynamic behavior during treatment.
  • Antibiotic therapy alone leads to resolution in only about a quarter of IIAs.
  • Saccular morphology may predict unfavorable IIA outcomes, whereas longer antibiotic treatment duration suggests a higher likelihood of resolution.
Keywords:
AngiogramAntibioticsInfectious intracranial aneurysm

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