Ruptured intracranial mycotic aneurysm: A rare cause of intracranial hemorrhage

Diagnostic and Therapeutic Considerations for “Mycotic” Cerebral Aneurysms – 2 Case Reports and Review of the Literature

“…Endocarditis and meningitis are well-known sources of infection causing cerebral aneurysms [11] . Of the patients with endocarditis, 2 -10 % will develop intracranial microbial aneurysms [31] and 10 -40 % of patients may encounter acute neurological deficits [20,22] . Based on this data, one would expect a 3 -4-fold higher frequency of cerebral aneurysms in infectious patients but cerebral angiography in these patients is not performed routinely and cerebral angiograms are not recommended in patients with bacterial endocarditis [8] .…”

“…Delayed treatment of infectious aneurysms has a poor outcome with high morbidity and mortality rates due to fulminant sepsis or / and hemorrhage at all sites [33] . Mortality rates of infectious cerebral aneurysms range between 39 -90 % depending on rupture of the cerebral aneurysm and infectious clinical course [29,31,35] . Poor prognostic factors are coma, cardiac failure, or infected valve prosthesis combined with the extent of neurological lesions [22] .…”

First Time Seizure in the Setting of a Congenital Heart Abnormality and MCA Mycotic Aneurysms

“…Approximately 10% of patients with endocarditis will develop neurovascular mycotic aneurysms. These mycotic aneurysms tend to be small, only a few millimeters, and prove fatal in 80% of cases when rupture occurs [ 3 ]. In general, the distal branches of the pial vessels, especially the MCA, are the most likely sites for seeding.…”