Infective endocarditis with cerebral mycotic aneurysm: treatment dilemma.

Cerebral mycotic aneurysms are uncommon but severe complications of infective endocarditis. Management of these patients remains controversial. We present a case of a 23-year-old man who had infective endocarditis complicated by an intracranial mycotic aneurysm. Because antimicrobial therapy was not effective in reducing the size of the mycotic aneurysm, a decision was made to perform craniotomy before cardiac surgery. The patient underwent an open heart operation 20 days after aneurysm clipping. His postoperative course was uneventful, and the patient continues to be healthy without neurological complications.