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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
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Republished: Intracranial vessel occlusion preceding the development of mycotic aneurysms in patients with

Ezequiel Goldschmidt1, Amir H Faraji1, David Salvetti1

  • 1Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Journal of Neurointerventional Surgery
|January 16, 2020
PubMed

Insights

Mycotic aneurysms (MA) are a rare complication of infectious endocarditis. Documented septic emboli on cerebral angiograms in patients with endocarditis may precede MA formation, indicating a risk factor.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Mycotic aneurysms (MA) are uncommon complications of infectious endocarditis.
  • The role of septic emboli in MA development is not well-established.

Observation:

  • Three cases of infectious endocarditis are presented, including two adults with intravenous drug use and one child with congenital heart disease.
  • Patients developed neurological symptoms during hospitalization.
  • Cerebral angiograms revealed vascular occlusions preceding MA development within one month.

Findings:

  • Septic emboli, visualized on cerebral angiograms, preceded mycotic aneurysm formation at the site of occlusion.
  • Documented angiographic emboli in infectious endocarditis patients with bacteremia are a risk factor for MA.

Implications:

  • This study suggests septic emboli are a direct precursor to mycotic aneurysms.
  • Patients with endocarditis and angiographic occlusions require vigilant monitoring for MA development.
Keywords:
aneurysmembolichemorrhageinfectioninflammation

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