Successful Surgical Treatment of an Intracranial Mycotic Aneurysm Complicated by a Subdural Hematoma

Treatment of Ruptured Spontaneous Saccular Aneurysm in the Central Artery of the Middle Cerebral Artery Using Bypass Surgery Combined With Trapping -Case Report-

“…3) Trapping and excision have also been used for aneurysms located at different cortical segments of the MCA. 1,6,11,12,15,17) In the present case, preoperative angiographic assessment of the location and shape of the aneurysm suggested the lesion could have been due to mycotic infection, neoplasm, or arterial dissection. In addition, the lesion was located in the central artery of the MCA.…”

“…Review of the 15 reported cases of aneurysms located at the cortical segment of the MCA showed that 14 cases resulted from infection and one occurred secondary to arterial dissection. 1,2,[5][6][7][9][10][11][12][15][16][17]19,20) Several surgical strategies for the treatment of distal MCA aneurysms have been reported. The first choice of the treatment for cerebral aneurysms is neck clipping, but this procedure is performed only for aneurysms located at the M 2 or M 3 segment of the MCA.…”

“…6) The most common etiology of distal MCA aneurysms is infection due to mycotic emboli with secondary aneurysm formation, 1,6,7,11,12,16,19) although arterial dissection can also cause secondary aneurysm formation. 15) Only one case of ruptured aneurysm located in the central artery of the MCA has been reported, which developed secondary to mycotic pseudoaneurysm.…”

Ruptured Infectious Aneurysm of the Distal Middle Cerebral Artery Manifesting as Intracerebral Hemorrhage and Acute Subdural Hematoma-Case Report-

“…[1][2][3]12,14,18,24,25,29) The incidence of acute SDH related to ruptured cerebral aneurysms is 0.3-7.9%. 5,10) Collectively, the incidence of ruptured infectious aneurysm associated with acute SDH should be extremely low.…”

“…19,30) However, ruptured intracranial infectious aneurysm manifesting as acute subdural hematoma (SDH) is quite rare, with only nine cases previously reported. [1][2][3]12,14,18,24,25,29) We treated a 21-year-old female with a ruptured distal middle cerebral artery (MCA) aneurysm presenting as ICH and SDH thought to be infectious in origin.…”