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Published on: September 25, 2009
Mycotic aneurysm presenting as subdural empyema: illustrative case
Joshua T M Lucas1, Shahed Elhamdani2, Seung W Jeong2
11Drexel University College of Medicine, Philadelphia, Pennsylvania; and.
Background:
Mycotic aneurysms (MAs) are rare intracranial pathologies. They are associated with spontaneous rupture, which is often the first presenting sign. Subarachnoid hemorrhage and intraparenchymal hemorrhage are the most common sequelae of ruptured MAs, with subdural hematoma being an atypical presentation. The presentation of an MA as a subdural empyema has not yet been reported in the literature.
Observations:
The authors discussed a 68-year-old man who presented with subdural empyema and received surgery for evacuation. He was found to have a ruptured mycotic aneurysm intraoperatively.
Lessons:
This case demonstrated a rare and atypical presentation of an MA.
Insights
Mycotic aneurysms (MAs) are rare intracranial conditions. This case highlights an MA presenting atypically as subdural empyema, a previously unreported manifestation.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Mycotic aneurysms (MAs) are uncommon intracranial vascular lesions.
- Rupture is a frequent initial clinical sign, typically leading to subarachnoid or intraparenchymal hemorrhage.
- Subdural hematoma is an unusual consequence, and presentation as subdural empyema is unprecedented.
Purpose of the Study:
- To report a unique case of a ruptured mycotic aneurysm presenting as subdural empyema.
- To emphasize the diverse clinical manifestations of mycotic aneurysms.
Main Methods:
- A case study of a 68-year-old male patient.
- Surgical intervention for subdural empyema with intraoperative discovery of a ruptured mycotic aneurysm.
Main Results:
- The patient presented with symptoms consistent with subdural empyema.
- Intraoperative findings revealed a ruptured mycotic aneurysm as the underlying cause.
Conclusions:
- This case represents the first reported instance of a mycotic aneurysm manifesting as subdural empyema.
- Mycotic aneurysms can present with highly atypical clinical and radiological findings.
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