Cerebral Mycotic Aneurysm Treated with Endovascular Occlusion —Case Report—

Watanabe, Akira; Hirano, Kazuhiro; Ishii, Ryoji

doi:10.2176/nmc.38.657

Cited by 41 publications

(23 citation statements)

References 4 publications

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“…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 . IIAs can be treated with antibiotic therapy alone, with an unpredictable evolution: they can regress, enlarge, stabilize or even rupture 6 .…”

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

confidence: 99%

Endovascular treatment for intracranial infectious aneurysms

Wajnberg

Rueda

Marchiori

et al. 2008

Arq. Neuro-Psiquiatr.

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-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.

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

confidence: 99%

Endovascular treatment for intracranial infectious aneurysms

Wajnberg

Rueda

Marchiori

et al. 2008

Arq. Neuro-Psiquiatr.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Saitō

Ogasawara

Kubo

et al. 2007

Neurol. Med. Chir.(Tokyo)

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“…Various treatments have been advocated 13,32) for treating infectious aneurysm, but the principal goals should be to eliminate the aneurysm from the circulation and to preserve flow to the distal vasculature. However, infectious aneurysms may incorporate the parent and distal vessels, especially in the distal MCA as well as in other locations, and are often difficult to obliterate without compromising cerebral blood flow.…”

Section: Discussionmentioning

confidence: 99%

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

Yamakawa

Hattori

Tanigawara

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 21-year-old woman with severe mitral valve regurgitation due to infectious endocarditis was transferred to our institute in a deep coma with intracerebral hemorrhage and acute subdural hematoma. She had no history of head injury. Brain computed tomography revealed left frontoparietal intracerebral hematoma and adjacent acute subdural hematoma that were evacuated on the day of admission, but the distal middle cerebral artery (MCA) aneurysm remained undetected. Follow-up cerebral angiography demonstrated the distal MCA aneurysm, which had enlarged by 25% at 2 weeks following the first operation. The aneurysm originated from a branch of the angular artery and was successfully resected on Day 22. Histological examination of the aneurysm section showed no infectious nature, but the final diagnosis was infectious intracranial aneurysm based on the presence of infectious endocarditis.

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Cerebral Mycotic Aneurysm Treated with Endovascular Occlusion —Case Report—

Abstract: A 56-year

Cited by 41 publications

References 4 publications

Endovascular treatment for intracranial infectious aneurysms

Endovascular treatment for intracranial infectious aneurysms

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

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

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