The role of serial angiography in the management of bacterial and fungal intracranial aneurysms--report of two cases and review of the literature.

Neurologia Medico-chirurgica
Y KojimaI Kim

Abstract

The authors review 149 cases of bacterial and mycotic intracranial aneurysms reported since 1957 and describe two cases of bacterial aneurysms managed in their institution. The overall mortality rate was 39%. Bacterial aneurysms accounted for 0.49-4.3% of all intracranial aneurysms. Among the reported cases, the mortality rate for patients treated with antibiotics alone was high, whereas it was low among those who underwent elective surgery. The authors conclude the following: 1) Distal aneurysms should be treated with high-dose antibiotics and followed with serial cerebral angiography at 7 days, 14 days, 1 month, 3 months, and 1 year after the initiation of therapy; 2) proximal aneurysms should be treated with high-dose antibiotics, and surgery is rarely indicated; 3) any significant associated hematoma should be evacuated and the aneurysm resected, if possible; and 4) if serial angiography shows enlargement of an aneurysm, surgery should be considered. The clinical features and management of mycotic and bacterial aneurysms are discussed in detail.

Citations

Aug 16, 2012·Neurosurgical Review·Bradley A Gross, Ajit S Puri
Feb 23, 2011·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Bernice G Gulek, Richard Rapport
Jan 31, 2002·Radiology·René ChapotJean-Jacques Merland
May 23, 2006·Pediatric Neurosurgery·Faiz Uddin AhmadAshish Suri
Feb 22, 2018·Journal of Neurointerventional Surgery·Ali AlawiehAlejandro M Spiotta
Mar 10, 2015·Neurologia Medico-chirurgica·Noriaki MatsubaraToshihiko Wakabayashi
Feb 8, 2006·Neurosurgery·Rebecca M SuggEdwin D Cacayorin

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