P Koch1, H A Desal, E Auffray-Calvier, A De Kersaint-Gilly. 1. Service de Neuroradiologie Diagnostique et Interventionnelle, Hôpital G&R Laënnec, CHU de Nantes, Bd Jacques Monod - St Herblain, 44093 Nantes Cedex 1, France.
Abstract
INTRODUCTION: mycotic intracranial aneurysms are a rare complication of infectious endocarditis. We report four cases of patients with endocarditis, complicated by an acute stroke, revealing a mycotic intracranial aneurysm. PATIENTS AND METHODS: four men (aged range 24 to 63 year old) were admitted for endocarditis, complicated by ischemic stroke in two cases and hemorrhagic stroke in the two other cases, including one with subarachnoid hemorrhage. Neuroimaging disclosed a mycotic cerebral aneurysm in all four cases. DISCUSSION: we will discuss the natural history and the management of mycotic intracranial aneurysm based on a review of the literature and our experience. Three therapeutic options are possible: medical treatment, surgery and endovascular embolisation. CONCLUSION: management of mycotic intracranial aneurysms is still controversial, frequently requiring a multidisciplinary strategy with priority given to endovascular interventions.
INTRODUCTION:mycotic intracranial aneurysms are a rare complication of infectious endocarditis. We report four cases of patients with endocarditis, complicated by an acute stroke, revealing a mycotic intracranial aneurysm. PATIENTS AND METHODS: four men (aged range 24 to 63 year old) were admitted for endocarditis, complicated by ischemic stroke in two cases and hemorrhagic stroke in the two other cases, including one with subarachnoid hemorrhage. Neuroimaging disclosed a mycotic cerebral aneurysm in all four cases. DISCUSSION: we will discuss the natural history and the management of mycotic intracranial aneurysm based on a review of the literature and our experience. Three therapeutic options are possible: medical treatment, surgery and endovascular embolisation. CONCLUSION: management of mycotic intracranial aneurysms is still controversial, frequently requiring a multidisciplinary strategy with priority given to endovascular interventions.