A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis

Peters, Philip J.; Harrison, Taylor; Lennox, Jeffrey L.

doi:10.1016/s1473-3099(06)70631-4

Cited by 201 publications

(210 citation statements)

References 36 publications

Supporting

Mentioning

195

Contrasting

Unclassified

Order By: Relevance

“…Since IAs can be clinically silent and some of them could resolve by antibiotic therapy, actual incidence of IAs is considered to be higher than the ones reported in the literatures [12]. IAs may result from septic embolism of vegetations to the arterial vasa vasorum or the intraluminal space, and result in subsequent spread of infection through the intima and outward the vessel wall [12]. Time interval from septic embolism to aneurysmal dilation can be as short as 24 hours [13].…”

Section: Discussionmentioning

confidence: 99%

“…Time interval from septic embolism to aneurysmal dilation can be as short as 24 hours [13]. Regardless of its high complication rate, at present, conventional CAG remains as gold standard in diagnosing intracranial IAs [1,12]. However, intracranial bleeding is not always secondary to rupture of IAs but often to other situations such as necrotic arteritis [14].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Morofuji

Morikawa

Tateishi

et al. 2010

Clinical Neurology and Neurosurgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Morofuji

Morikawa

Tateishi

et al. 2010

Clinical Neurology and Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Intracranial infectious aneurysms (IIA), previously known as mycotic aneurysms, typically develop in the presence of bacterial endocarditis 1 . Neurological complications develop in 20% to 40% of infectious endocarditis patients 2 , and only 5% are caused by a ruptured aneurysm 3 .…”

Section: Dr Eduardo Wajnberg -Rua Lopes Quintas 100 / 602 -22460-010mentioning

confidence: 99%

“…Most of these aneurysms are distal and involve the middle cerebral artery 1,2 . The overall mortality rate among these patients is 60%, and increases to 80% in cases associated with subarachnoid hemorrhage (SAh) 2,4,5 .…”

Section: Dr Eduardo Wajnberg -Rua Lopes Quintas 100 / 602 -22460-010mentioning

confidence: 99%

“…Another cause of brain complication in untreated endocarditis is intracranial hemorrhage caused by septic emboli that achieve the cerebral arteries, during uncontrolled bacteremia, causing erosive arteritis 1,15 . There is also a possibility of sterile emboli cause ischemic infarct that undergo secondary hemorrhagic transformation 15 .…”

Section: Fig 2 Patient 3 (A) Ct Scan After Neurological Event Reveamentioning

confidence: 99%

See 1 more Smart Citation

Endovascular treatment for intracranial infectious aneurysms

Wajnberg

Rueda

Marchiori

et al. 2008

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-Objetive:To re-enforce an alternative, less aggressive treatment modality in the management of intracranial infectious aneurysms. Method: We present a series of five patients with infectious endocarditis and intracranial infectious aneurysms (mycotic aneurysms) managed by means of endovascular treatment. Results: Endovascular treatment was executed technically uneventfully in all patients. Three patients had favorable clinical outcome: two were classified as Glasgow Outcome Scale 4/5, and one had total neurological recovery (GOS 5/5). Two patients died (GOS 1/5), one in consequence of the initial intracranial bleeding and the other after cardiac complications from endocarditis and open-heart surgery. Conclusion: Endovascular techniques are an expanding option for the treatment of IIAs. It has been especially useful for infectious endocarditis patients with IIA, who will be submitted to cardiac surgery with cardiopulmonary bypass and anticoagulation, with the risk of intracranial bleeding.KEy WOrdS: infectious aneurysms, cerebral, embolization tratamento endovascular de aneurismas infecciosos intracranianosResumo -Objetivo: Enfatizar o método endovascular como uma opção de tratamento alternativa e menos agressiva no tratamento de aneurismas infecciosos intracranianos. Método: Apresentamos uma série de cinco pacientes com endocardite infecciosa e aneurismas infecciosos intra-cranianos (aneurismas micóticos) tratados através da via endovascular. Resultados: O tratamento endovascular teve sucesso técnico e sem intercorrências relacionadas ao cateterismo em todos os casos. Três pacientes tiveram desfecho clínico favorável: dois com escala de regeneração de Glasgow 4/5 e um com recuperação neurológica completa (GOS 5/5). dois pacientes tiveram desfecho desfavorável (GOS 1/5), um devido às conseqüências do sangramento intracraniano inicial e outro devido a complicações cardíacas da endocardite e cirurgia de troca valvar. Conclusão: As técnicas endovasculares são uma nova opção de tratamento dos aneurismas infecciosos intracranianos. Ela é especialmente útil em pacientes que serão submetidos à cirurgia cardíaca com circulação extra-corpórea e anticoagulação, com o conseqüente risco de hemorragia intracraniana.PAlAvrAS-chAvE: aneurismas infecciosos, cerebral, embolização.

show abstract

Stroke due to Systemic Diseases

Morales-Vidal

Biller

2013

Neurological Disorders Due to Systemic Disease

View full text Add to dashboard Cite

A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis

Cited by 201 publications

References 36 publications

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Endovascular treatment for intracranial infectious aneurysms

Stroke due to Systemic Diseases

Contact Info

Product

Resources

About