Fig 2 - uploaded by Tomohiko Ozaki
Content may be subject to copyright.
Case 1. (A and B) Left common carotid artery angiogram revealed an infectious intracranial aneurysm on the left central artery. (A) anterior-posterior view, (B) lateral view (C and D) Aneurysm is on the distal part of the left central artery (white arrow). The affected artery is very small and navigation of microcatheter was thought to be difficult (white arrow head).
Source publication
Objective: Aggressive therapeutic intervention is recommended for infectious intracranial aneurysms (IIAs) because they have a higher hemorrhage risk than non-IIAs. In this study, we retrospectively reviewed patients with IIAs treated at our institution and evaluated the contents of treatment and the complications.
Methods: We evaluated 13 patients...
Context in source publication
Context 1
... diameter accompanied by localized old subarachnoid hemorrhage and edema in a deep area of the left central sulcus ( Fig. 1). Because of her history of uterine cervical cancer, she was initially suspected to have metastatic brain tumor and referred to our department, but an aneurysm was detected in the left central artery on cerebral angiography (Fig. 2). Additional systemic examinations demonstrated the underlying IE, and she was eventually diagnosed with IIA due to IE. Since the lesion was located in the peripheral middle cerebral artery, navigation of the catheter to the lesion was expected to be unachievable, and aneurysmectomy was performed by craniotomy 1 month after the ...
Similar publications
Aneurysm rebleeding following initial endovascular management is uncommon, and the factors associated with its occurrence are poorly defined. We retrospectively analyzed a consecutive series of patients presenting with aneurysmal subarachnoid hemorrhage who underwent endovascular management to determine factors associated with rebleeding. Rebleedin...
Citations
... 14) Regarding treatment for aneurysms include surgical trapping, clipping, and endovascular coiling and trapping. 1,15) Endovascular surgery has become an important treatment for mycotic aneurysm. Many patients with deteriorating conditions and those who have vegetations and require cardiothoracic surgery have been treated with endovascular surgery. ...
... 2) Many reports suggested that endovascular treatment does not cause complications including infection. 15) The pearl-and-string sign can be a tool for making the diagnosis. Nevertheless, the imaging of both diseases shows various types of aneurysm and it is difficult to make the diagnosis using only imaging. ...
Objective: We present a case of subarachnoid hemorrhage (SAH) due to ruptured mycotic aneurysm found in the distal superior cerebellar artery (SCA).
Case Presentation: A 64-year-old man was admitted to our hospital with sudden unconsciousness. He had a history of alcoholism but no family history of SAH. Computed tomography (CT) showed apparent SAH; however, CT angiography (CTA) showed no apparent cause of SAH except for two small aneurysms in the same branch of the left distal SCA. We suspected mycotic aneurysm and prescribed antibiotics. It was difficult to diagnose the condition as mycotic aneurysm because there were no vegetations or caries at the time of admission. Because there were two aneurysms in the same branch with partial dilatation and stenosis, we suspected dissecting aneurysm, but continued to administer antibiotics for possible mycotic aneurysm. After the first operation, we diagnosed mycotic aneurysm because a vegetation and valve degeneration was found.
Conclusion: It is difficult to distinguish mycotic aneurysms from dissecting aneurysms because of similar appearance on imaging, especially if no vegetation is found. Nevertheless, it is important to start treatment for mycotic aneurysm. If there is the possibility of mycotic aneurysm, appropriate antibiotics should be administered, and endovascular treatment could be considered for patients with deteriorating conditions.
