Conservative treatment of a ruptured inflammatory infectious aneurysm caused by neurocysticercosis

Márquez-Romero, Juan Manuel; Santana-López, Juan Manuel; Espinoza-López, Dulce Anabel; Zermeño, Fernando

doi:10.1016/j.clineuro.2011.12.050

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Kim et al 14 were the only authors to perform histological analysis of the aneurysm wall; the analysis showed diffuse lymphocytic infiltration and thinning of the vessel wall with no internal elastic lamina, which are common findings in IIAs. Marquez-Romero et al 17 and Cárdenas et al 6 reported on the conservative treatment of an MCA aneurysm with albendazole and prednisone with good clinical and radiological results, what has also been demonstrated for IIA of other etiologies. We, therefore, believe that there is sufficient evidence that NCC, in its subarachnoid form, through an extravascular inflammatory mechanism affecting the wall of the involved vessel, may lead to the development of an IIA and should be listed among the possible etiological agents, along with bacterial and fungal agents.…”

Section: Infectious Intracranial Aneurysms and Snccmentioning

confidence: 81%

“…11 The acquisition of FLAIR se-quences after 5 minutes of continuous inhalation of 100% supplemental oxygen may have a higher sensitivity for cysticercus visualization. 4 Although there is report of success with the conservative treatment with albendazole at high doses (30 mg/ kg/day) and corticosteroids (intravenous dexamethasone 24 mg/day, followed by oral prednisone 1 mg/kg/day), 17 we do not recommend such an approach. Unlike antibiotic treatment for IIAs from a bacterial or fungal origin, there is doubt about the efficacy of cysticidal drugs for the treatment of SNCC.…”

Section: Infectious Intracranial Aneurysms and Snccmentioning

confidence: 98%

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Subarachnoid neurocysticercosis and an intracranial infectious aneurysm: case report

Vieira¹,

Faquini²,

Silva³

et al. 2019

Neurosurgical Focus

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Infectious intracranial aneurysms (IIAs) represent 2%–6% of all intracranial aneurysms and, classically, have been associated with bacterial or fungal agents. The authors report the case of a 42-year-old woman who presented with a typical history of subarachnoid hemorrhage. Digital subtraction angiography (DSA) showed an aneurysmal dilatation on the frontal M2 segment of the left middle cerebral artery (MCA). The patient was treated surgically, and multiple cysts were found in the left carotid and sylvian cisterns, associated with a dense inflammatory exudate that involved the MCA. The cysts were removed, and a fusiform aneurysmal dilatation was identified. The lesion was not amenable to direct clipping, so the authors wrapped it. Histopathological analysis of the removed cysts revealed the typical pattern of subarachnoid neurocysticercosis. The patient received cysticidal therapy with albendazole and corticosteroids, and she recovered uneventfully. Follow-up DSA performed 6 months after surgery showed complete resolution of the aneurysm. The authors performed a review of the literature and believe that there is sufficient evidence to affirm that the subarachnoid form of neurocysticercosis may lead to the development of an IIA and that Taenia solium should be listed among the possible etiological agents of IIAs, along with bacterial and fungal agents.

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Section: Infectious Intracranial Aneurysms and Snccmentioning

confidence: 81%

Section: Infectious Intracranial Aneurysms and Snccmentioning

confidence: 98%

Subarachnoid neurocysticercosis and an intracranial infectious aneurysm: case report

Vieira¹,

Faquini²,

Silva³

et al. 2019

Neurosurgical Focus

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“…The radiological outcome for treated aneurysms was described for 37 patients and showed a complete occlusion in 13 patients [11,14,16,19,23,25,26,28,31]. Decreases in size or radiologicall y unchanged aneurysms were mentioned in 17 patients [1,11,16,17,19].…”

Section: Resultsmentioning

confidence: 99%

“…After screening of the titles and abstracts, 63 studies were selected for full review [1,3,4,7,10,11,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71]. Thirty studies with 2 or more patients and 33 case reports with a total number of 814 patients were identified.…”

Section: Resultsmentioning

confidence: 99%

Interdisciplinary Treatment of Intracranial Infectious Aneurysms

Hamisch¹,

Mpotsaris

Timmer³

et al. 2016

Cerebrovasc Dis

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Objective: Intracranial infectious aneurysms (IIAs) are a rare clinical entity without a definitive treatment guideline. In this study, we evaluate the treatment options of these lesions based on our own clinical experience and review the current knowledge of therapy as portrayed in the literature. Methods: We conducted a single-center retrospective analysis of all patients with an IIA and performed a systematic review of the literature using the MEDLINE database. We undertook a comprehensive literature search using the OVID gateway of the MEDLINE database (1950-October 2015) using the following keywords (in combination): ‘infectious', ‘mycotic', ‘cerebral aneurysm', ‘intracranial aneurysm'. 1,721 potentially relevant abstracts were identified and 63 studies were selected for full review. The studies were analysed regarding ruptured versus unruptured aneurysms, aneurysm localization and treatment, as well as clinical and radiological outcome. Results: Our institutional series consisted of 6 patients (median age 57 [32-76]) treated between 2011 and 2015. All patients presented with ruptured IIAs located on the middle cerebral artery (MCA, 5 patients) and anterior cerebral artery (ACA, 1 patient). Five patients were treated by clipping and resecting the aneurysm, 1 patient underwent coiling. All patients received antibiotic therapy and 1 patient died. We further identified 814 patients (median age 35.5 [0-81]) in 63 studies. Locations of the aneurysms were mentioned in 55 studies. The most frequent locations of the aneurysms were: MCA (63.5%), posterior cerebral artery (14%), ACA (9.0%) and others (13.5%). Treatment for IIAs was described in 62 studies: antibiotic treatment (56.1%), a combination of antibiotics and surgery (20.9%) or antibiotics and endovascular treatment (23.0%). Outcome was mentioned in 82.4% of the patients with a mortality rate of 16.8%. An evaluation of treatment outcome was limited due to the heterogeneity of patients in the published case series. Conclusion: Antibiotic therapy of patients with IIA is mandatory. However, due to the complexity of the disease and its accompanying comorbidities, a general treatment algorithm could not be defined. Analogous to non-mycotic aneurysms, further treatment decisions require an interdisciplinary approach involving neurosurgeons, interventionists and infectious disease specialists.

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Aneurysm, ischemic stroke and cysticercosis

Wiwanitkit

2014

Clinical Neurology and Neurosurgery

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Conservative treatment of a ruptured inflammatory infectious aneurysm caused by neurocysticercosis

Cited by 4 publications

References 5 publications

Subarachnoid neurocysticercosis and an intracranial infectious aneurysm: case report

Subarachnoid neurocysticercosis and an intracranial infectious aneurysm: case report

Interdisciplinary Treatment of Intracranial Infectious Aneurysms

Aneurysm, ischemic stroke and cysticercosis

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