A young man with headache was unable to sneeze despite a strong sensory urge to do so. Magnetic resonance imaging revealed a cystic neoplasm in the medulla oblongata that presumably interrupted the efferent arc of the sneezing reflex.
A case of repeated intracranial aneurysmal rupture occurring despite successful treatment of infective endocarditis is reported. While the valvular source of emboli was eradicated and serial angiograms documented no further aneurysms after resection of the primary lesion, the formation and rupture of multiple septic aneurysms occurred 9 months later in the opposite hemisphere. A relationship to damage of the cerebral vasculature by immune complexes is suggested as one possible explanation for this unusual occurrence. This implies that some patients with infective endocarditis may be at permanent risk for the formation and rupture of mycotic intracranial aneurysms, despite successful treatment of the primary cardiac lesion.
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