[Cerebral mycotic aneurysms after abortion endometritis]

The genesis of abortion endometritis appears to be sufficiently clarified when the aneurysm was successfully demonstrated and the vascular bulgings were located at the typical sites of predilection of Forbus' malformation aneurysms. The demonstrated case shows that this conception is not generally valid and that surprising aspects can be derived from pathological-anatomic findings. A 43-year-old female patient had her third subarachnoid haemorrhage on the second day of admission before a neurosurgical operation could be performed and died of the consequences of this haemorrhage. The histological examination spoke for an embolic-mycotic aneurysm genesis in the presence of abortion endometritis. In the literature, the majority of cerebral mycotic aneurysms are described as a consequence of endometritis, only 20 per cent are due to other inflammatory basic diseases. If cerebral vessels are invaded by bacteria, wall structure, tissue reaction and clinical manifestation are dependent upon the virulence of the pathogens an the defense power of the patient. In case of clinically manifest infectious processes and subarachnoid haemorrhage are coinciding, an inflammatory affection of cerebral vessels should be included in the scope of differential-diagnostic considerations. The establishment of correlations becomes more difficult in case of an apparently inconspicuous interval of several months. That neglected symptoms of an (extracerebral) infection can be in direct connection with cerebral aneurysms haemorrhages is shown by the description of a case with cerebral mycotic aneurysms after endometritis not having been described in the literature until now.