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Updated: Jan 25, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Trends in Intervention Modality for Hospitalizations with Infectious Intracranial Aneurysms: A Nationwide Analysis.

Giana Dawod1, Alis J Dicpinigaitis1, Cenai Zhang1

  • 1Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|January 23, 2026
PubMed
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Treatment for infectious intracranial aneurysms shifted towards endovascular methods, with no change in overall intervention rates or patient mortality. This trend occurred without adverse effects on outcomes.

Keywords:
AneurysmDatabaseEndovascularInfectiousIntracranialMycoticSurgery

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Infectious intracranial aneurysms (IIAs) are rare but serious complications of infective endocarditis.
  • Optimal treatment strategies for IIAs remain incompletely defined.
  • Cerebrovascular disease management increasingly incorporates endovascular techniques.

Purpose of the Study:

  • To analyze trends in endovascular versus neurosurgical treatment of IIAs.
  • To investigate the impact of treatment modality on patient outcomes.

Main Methods:

  • Retrospective analysis of the National Inpatient Sample (2000-2019).
  • Identification of hospitalizations with IIAs in the context of infective endocarditis.
  • Categorization of treatments into endovascular and open neurosurgical repair using ICD codes.
  • Logistic regression to assess treatment modality's association with in-hospital mortality and discharge disposition.

Main Results:

  • 24,461 hospitalizations with IIAs were identified.
  • Overall intervention rates remained stable at 5.8%.
  • Endovascular repair rates significantly increased (APC=3.6%), while open neurosurgical repair rates significantly decreased (APC=-5.4%).
  • Treatment modality did not significantly impact in-hospital mortality or non-home discharge.

Conclusions:

  • While overall intervention rates for IIAs did not change, there was a significant shift from open neurosurgery to endovascular treatment.
  • This shift in treatment modality did not adversely affect mortality or discharge disposition.
  • Future research should focus on identifying predictors of favorable outcomes and optimal procedural timing.