Mycotic aneurysm presenting as subdural empyema: illustrative case

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.