Mycotic intracavernous carotid aneurysm

Yuen, Tanya; Laidlaw, John D.; Mitchell, Peter

doi:10.1016/j.jocn.2004.02.004

Cited by 10 publications

(6 citation statements)

References 57 publications

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“…14 PAO using permanent liquid embolics or detachable balloons have also been described in literature. 15,16 In our case, owing to the saccular aneurysm with good neck, we successfully performed coil embolization of the aneurysm preserving the parent artery with no post-procedure deficits.…”

Section: Discussionmentioning

confidence: 73%

Endovascular Treatment of Distal Posterior Cerebral Artery Infectious Aneurysm

Bohara

Bista

2020

Nep J Neurosci

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Intracranial infectious aneurysms are rare entities accounting for approximately 1- 6 % of all cerebral aneurysms and have high propensity of rupture associated with mortality. The principal risk factor is infective endocarditis and the management includes antimicrobial treatment with or without obliteration of the aneurysm by microsurgical or endovascular means. We present a young patient with intracranial infectious aneurysm who was successfully treated with endovascular coil embolization. A 20-years-old female with history of rheumatic heart disease presented with subarachnoid hemorrhage due to rupture of IIA associated with infective endocarditis. Cerebral angiogram revealed right distal posterior cerebral artery aneurysm. Echocardiography showed vegetation in mitral valve and blood culture was positive for Enterococcus faecalis. Antibiotic treatment was administered for 6 weeks. The follow-up angiogram showed an enlarging aneurysm. So, the patient underwent endovascular coil embolization of the aneurysm preserving the parent artery. There were no post-procedure deficits. Intracranial infectious aneurysm should be considered as a differential diagnosis in a patient with infective endocarditis presenting with focal neurological deficits or altered consciousness. Early diagnosis and individualized approach are the key to successful treatment and endovascular treatment is an effective modality for such lesions.

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Section: Discussionmentioning

confidence: 73%

Endovascular Treatment of Distal Posterior Cerebral Artery Infectious Aneurysm

Bohara

Bista

2020

Nep J Neurosci

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“…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%

“…There was no radiologic follow-up for 49 aneurysms, out of which 12 patients had died prior to postinterventional radiologic work-up. Yuen et al [46] reported of a patient with an aneurysm rupture after balloon occlusion. The patient died due to the sequelae of the hemorrhage.…”

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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“…this complication results from factors such as thromboembolism from an acutely occluded carotid artery, or delayed failure of a collateral vessel. the usual causes 2,[4][5][6][7] . the rare cavernous carotid mycotic aneurysms are thought to be caused by local cavernous sinus inflammation 3,8 .…”

Section: Endovascular Proceduresmentioning

confidence: 99%

“…Mycotic aneurysm, an infection-related false aneurysm, is a rare entity and represents only 2-5% of all intracranial aneurysms 1 . these are usually located in distal branches of the middle cerebral arteries particularly at the bifurcation point 2 . Intracavernous carotid aneurysm (Icca) accounts for 3-5% of all intracranial aneurysms 3 .…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of a Mycotic Intracavernous Carotid Artery Aneurysm Using a Stent Graft

et al. 2013

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Intracavernous carotid artery mycotic aneurysms are rare and management is determined by clinical presentation. We describe the first documented proximal intracranial mycotic aneurysm treated by a balloon expandable Aneugraft PCS covered stent. An 11-year-old female child presented with acute onset fever, headache, chemosis followed by diplopia, right-sided ptosis with ophthalmoplegia. Magnetic resonance imaging revealed bilateral cavernous sinus thrombosis. Subsequent work-up included serial computed tomographic arteriography and digital subtraction angiography which revealed a progressively enlarging intracavernous carotid aneurysm. An Aneugraft PCS covered stent was successfully deployed endovascularly, and complete exclusion of the aneurysm was achieved while maintaining the patency of the parent artery. The use of covered stents in intracranial vasculature can be an effective and safe treatment modality for exclusion of the mycotic aneurysm in selected cases.

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Mycotic intracavernous carotid aneurysm

Cited by 10 publications

References 57 publications

Endovascular Treatment of Distal Posterior Cerebral Artery Infectious Aneurysm

Endovascular Treatment of Distal Posterior Cerebral Artery Infectious Aneurysm

Interdisciplinary Treatment of Intracranial Infectious Aneurysms

Endovascular Treatment of a Mycotic Intracavernous Carotid Artery Aneurysm Using a Stent Graft

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