Infectious intracranial aneurysms (IIAs) are rare but can cause substantial morbidity and mortality. We aimed to re-evaluate the role of endovascular therapy for the treatment of IIAs.
This study is a retrospective review of patients diagnosed with IIAs and treated by endovascular therapy in our institutions over the past 13 years.
Four patients were diagnosed with infectious endocarditis with a total of 5 IIAs. Three of the 4 patients had ruptured IIAs. Two presented with intracerebral hemorrhage, one with subarachnoid hemorrhage, and one with cerebral infarction. The distal middle cerebral artery (MCA) was the most common site, followed by the distal segment of the posterior cerebral artery. Three patients were treated by parent artery occlusion and one by direct aneurysm obliteration. There were no periprocedural complications. One IIA treated by direct aneurysm occlusion was recanalized within 1 year and required a second embolization. Outcomes were measured by the modified Rankin Scale on discharge: 2 patients scored 0, 1 patient scored 1, and 1 patient scored 3.
IIAs located deep in the brain or on the peripheral MCA can be safely treated with endovascular therapy even when they are lying in the eloquent cortex.
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- Current multimodality management of infectious intracranial aneurysm.Neurosurgery. 2001; 48: 1203-1214
- Distal middle cerebral artery aneurysms. Endovascular treatment results with literature review.Interv Neuroradiol. 2002; 8: 399-407
- Neurologic complications of infective endocarditis.Neurol Clin. 1993; 11: 419-440
- Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases.Surg Neurol. 2006; 66: 405-410
- Endovascular treatment of bacterial intracranial aneurysms.Neuroradiology. 1996; 38: 186-189
- Endocarditis-related cerebral aneurysms: radiologic changes with treatment.AJNR Am J Neuroradiol. 1995; 16: 745-748
- Bacterial intracranial aneurysms.J Neurosurg. 1980; 53: 633-641
- Treatment of a bacterial (mycotic) intracranial aneurysm using an endovascular approach.Neurosurgery. 1993; 32: 852-854
- Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils.AJNR Am J Neuroradiol. 1999; 20: 308-310
- The importance of repeated angiography in the treatment of mycotic-embolic intracranial aneurysm.J Neurosurg. 1966; 25: 189-193
- Microsurgical management of distal middle cerebral artery aneurysms.Surg Neurol. 2007; 67: 553-563
- Microsurgical anatomy of the middle cerebral artery.J Neurosurg. 1981; 54: 151-169
Published online: December 29, 2015
Accepted: November 22, 2015
Received in revised form: November 19, 2015
Received: July 16, 2015
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.