Skip to main content
SpringerLink
Log in

Infectious Intracranial Aneurysms: Epidemiology, Pathophysiology, and Management

  • Chapter
  • First Online:
Management of Cerebrovascular Disorders

  • 1104 Accesses

Abstract

Infectious intracranial aneurysms (IIAs) are rare cerebrovascular lesions caused by the spread of microbial infection to the arterial vessel wall leading to weakening and aneurysmal dilatation. IIAs were initially described by Osler in 1885 as aneurysmal complications of infective endocarditis (IE) and were called “mycotic aneurysms” (MA). The term “mycotic” was not used to indicate a fungal etiology since MA are mostly caused by bacterial infections; rather, it described the appearance of these aneurysms that mimic fungal vegetation. Due to the rare nature of the disease, studies on IIAs are limited to case reports, case series, and retrospective studies that are not sufficient to draw generalizable conclusions on the epidemiology, management, and outcomes of IIAs. However, it is anticipated that IIAs account for 0.5–6.5% of all aneurysms and are associated with high risk of rupture and mortality. Treatment of IIAs may range from conservative medical management with antibiotic therapy and close monitoring, to endovascular embolization, to microsurgical clipping or excision of the aneurysms. In this chapter, we review the pathophysiology, epidemiology, and management of IIAs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Osler W. The Gulstonian lectures, on malignant endocarditis. Br Med J. 1885;1(1264):577–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Wang JL, Hinduja AP, Powers CJ. Successful coil embolization of a ruptured mycotic aneurysm that developed three days after septic embolic infarction: case report and review of the literature. J Clin Neurosci. 2017;39:95–8.

    PubMed  Google Scholar 

  3. Jiad E, Gill SK, Krutikov M, Turner D, Parkinson MH, Curtis C, et al. When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis. Pract Neurol. 2017;17(1):28–34.

    PubMed  Google Scholar 

  4. Zhong X, Li X, Shao S, Yang X, Fan X. A case of infectious intracranial dissecting aneurysm. Neurol India. 2017;65(2):405–7.

    PubMed  Google Scholar 

  5. Remirez JM, Sabet Y, Baca M, Maud A, Cruz-Flores S, Rodriguez GJ, et al. Mycotic intracranial aneurysm secondary to left ventricular assist device infection. J Vasc Interv Neurol. 2017;9(3):23–5.

    PubMed  PubMed Central  Google Scholar 

  6. Piccirilli M, Prizio E, Cannizzaro D, Tropeano MP, Guidetti G, Santoro A. The only case of mycotic aneurysm of the PICA: clinical-radiological remarks and review of literature. J Clin Neurosci. 2017;38:62–6.

    PubMed  Google Scholar 

  7. Palacios A, Llorente AM, Ordonez O, Martinez de Aragon A. Intracranial mycotic aneurysm in a 5 month-old infant with pneumococcal meningitis. Enferm Infecc Microbiol Clin. 2017;35(4):267–9.

    PubMed  Google Scholar 

  8. Lin CT, Tranmer B, Durham S, Johnson D, Hamlin M, Bolman RM 3rd. Ruptured mycotic aneurysm and cerebral vasospasm in the setting of endocarditis and heart failure requiring cardiothoracic surgery: case report and literature review. World Neurosurg. 2017;100:711 e13–8.

    Google Scholar 

  9. Champeaux C, Walker N, Derwin J, Grivas A. Successful delayed coiling of a ruptured growing distal posterior cerebral artery mycotic aneurysm. Neuro-Chirurgie. 2017;63(1):17–20.

    CAS  PubMed  Google Scholar 

  10. Schneider MA, Pomidor MA. Cerebral mycotic aneurysm and infective endocarditis: a case study. J Neurosci Nurs. 2016;48(2):100–4.

    PubMed  Google Scholar 

  11. Rhodes HM, Hirigoyen D, Shabnam L, Williams DN, Hansen GT. Infective endocarditis due to Abiotrophia defectiva and Granulicatella spp. complicated by infectious intracranial cerebral aneurysms: a report of three cases and review of the literature. J Med Microbiol. 2016;65(6):493–9.

    PubMed  Google Scholar 

  12. Nonaka S, Oishi H, Tsutsumi S, Teranishi K, Tanoue S, Yasumoto Y, et al. Endovascular therapy for infectious intracranial aneurysm: a report of four cases. J Stroke Cerebrovasc Dis. 2016;25(3):e33–7.

    PubMed  Google Scholar 

  13. Lv N, Zhou Y, Yang P, Li Q, Zhao R, Fang Y, et al. Endovascular treatment of distal middle cerebral artery aneurysms: report of eight cases and literature review. Interv Neuroradiol. 2016;22(1):12–7.

    PubMed  PubMed Central  Google Scholar 

  14. John S, Walsh KM, Hui FK, Sundararajan S, Silverman S, Bain M. Dynamic angiographic nature of cerebral mycotic aneurysms in patients with infective endocarditis. Stroke. 2016;47(1):e8–e10.

    PubMed  Google Scholar 

  15. Hamisch CA, Mpotsaris A, Timmer M, Reiner M, Stavrinou P, Brinker G, et al. Interdisciplinary treatment of intracranial infectious aneurysms. Cerebrovasc Dis. 2016;42(5–6):493–505.

    PubMed  Google Scholar 

  16. Fusco MR, Stapleton CJ, Griessenauer CJ, Thomas AJ, Ogilvy CS. Endovascular treatment of intracranial infectious aneurysms in eloquent cortex with super-selective provocative testing: case series and literature review. Interv Neuroradiol. 2016;22(2):148–52.

    PubMed  Google Scholar 

  17. Grandhi R, Zwagerman NT, Linares G, Monaco EA 3rd, Jovin T, Horowitz M, et al. Onyx embolization of infectious intracranial aneurysms. J Neurointerv Surg. 2014;6(5):353–6.

    PubMed  Google Scholar 

  18. Ota T, Yoshino M, Horiba A, Yokoya S, Mizutani T. Ruptured infectious aneurysms of the distal MCA treated with trapping and STA-MCA bypass surgery. Br J Neurosurg. 2012;26(5):767–9.

    PubMed  Google Scholar 

  19. Hourihane JB. Ruptured mycotic intracranial aneurysm. A report of three cases. Vasc Surg. 1970;4(1):21–9.

    CAS  PubMed  Google Scholar 

  20. Cantu RC, LeMay M, Wilkinson HA. The importance of repeated angiography in the treatment of mycotic-embolic intracranial aneurysms. J Neurosurg. 1966;25(2):189–93.

    CAS  PubMed  Google Scholar 

  21. Ziment I, Johnson BL Jr. Angiography in the management of intracranial mycotic aneurysms. Arch Intern Med. 1968;122(4):349–52.

    CAS  PubMed  Google Scholar 

  22. Suwanwela C, Suwanwela N, Charuchinda S, Hongsaprabhas C. Intracranial mycotic aneurysms of extravascular origin. J Neurosurg. 1972;36(5):552–9.

    CAS  PubMed  Google Scholar 

  23. Horten BC, Abbott GF, Porro RS. Fungal aneurysms of intracranial vessels. Arch Neurol. 1976;33(8):577–9.

    CAS  PubMed  Google Scholar 

  24. Bingham WF. Treatment of mycotic intracranial aneurysms. J Neurosurg. 1977;46(4):428–37.

    CAS  PubMed  Google Scholar 

  25. Roach MR, Drake C. Ruptured cerebral aneurysms caused by micro-organisms. N Eng J Med. 1965;273(5):240–4.

    Google Scholar 

  26. McNeel D, Evans RA, Ory EM. Angiography of cerebral mycotic aneurysms. Acta Radiol Diagn (Stockh). 1969;9:407–12.

    CAS  Google Scholar 

  27. Gilroy J, Andaya L, Thomas VJ. Intracranial mycotic aneurysms and subacute bacterial endocarditis in heroin addiction. Neurology. 1973;23(11):1193–8.

    CAS  PubMed  Google Scholar 

  28. Ishikawa M, Waga S, Moritake K, Handa H. Cerebral bacterial aneurysms: report of three cases. Surg Neurol. 1974;2(4):257–61.

    CAS  PubMed  Google Scholar 

  29. Moskowitz MA, Rosenbaum AE, Tyler HR. Angiographically monitored resolution of cerebral mycotic aneurysms. Neurology. 1974;24(12):1103–8.

    CAS  PubMed  Google Scholar 

  30. Bullock R, van Dellen JR, van den Heever CM. Intracranial mycotic aneurysms. A review of 9 cases. S Afr Med J = Suid-Afrikaanse tydskrif vir geneeskunde. 1981;60(25):970–3.

    CAS  PubMed  Google Scholar 

  31. Day AL. Extracranial-intracranial bypass grafting in the surgical treatment of bacterial aneurysms: report of two cases. Neurosurgery. 1981;9(5):583–8.

    CAS  PubMed  Google Scholar 

  32. Bullock R, Van Dellen JR. Rupture of bacterial intracranial aneurysms following replacement of cardiac valves. Surg Neurol. 1982;17(1):9–11.

    CAS  PubMed  Google Scholar 

  33. Morawetz RB, Karp RB. Evolution and resolution of intracranial bacterial (mycotic) aneurysms. Neurosurgery. 1984;15(1):43–9.

    CAS  PubMed  Google Scholar 

  34. Dean RH, Waterhouse G, Meacham PW, Weaver FA, O'Neil JA Jr. Mycotic embolism and embolomycotic aneurysms. Neglected lessons of the past. Ann Surg. 1986;204(3):300–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. O’Donohue JM, Enzmann DR. Mycotic aneurysm in angiitis associated with herpes zoster ophthalmicus. AJNR Am J Neuroradiol. 1987;8(4):615–9.

    PubMed  Google Scholar 

  36. Barrow DL, Prats AR. Infectious intracranial aneurysms: comparison of groups with and without endocarditis. Neurosurgery. 1990;27(4):562–72. discussion 72–3.

    CAS  PubMed  Google Scholar 

  37. Kanter MC, Hart RG. Cerebral mycotic aneurysms are rare in infective endocarditis. Ann Neurol. 1990;28(4):590–1.

    CAS  PubMed  Google Scholar 

  38. Masuda J, Yutani C, Waki R, Ogata J, Kuriyama Y, Yamaguchi T. Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis. Stroke. 1992;23(6):843–50.

    CAS  PubMed  Google Scholar 

  39. Ahmadi J, Tung H, Giannotta SL, Destian S. Monitoring of infectious intracranial aneurysms by sequential computed tomographic/magnetic resonance imaging studies. Neurosurgery. 1993;32(1):45–9. discussion 9–50.

    CAS  PubMed  Google Scholar 

  40. Khayata MH, Aymard A, Casasco A, Herbreteau D, Woimant F, Merland JJ. Selective endovascular techniques in the treatment of cerebral mycotic aneurysms. Report of three cases. J Neurosurg. 1993;78(4):661–5.

    CAS  PubMed  Google Scholar 

  41. Cunha e Sa M, Sisti M, Solomon R. Stereotactic angiographic localization as an adjunct to surgery of cerebral mycotic aneurysms: case report and review of the literature. Acta Neurochir. 1997;139(7):625–8.

    PubMed  Google Scholar 

  42. Chapot R, Houdart E, Saint-Maurice JP, Aymard A, Mounayer C, Lot G, et al. Endovascular treatment of cerebral mycotic aneurysms. Radiology. 2002;222(2):389–96.

    PubMed  Google Scholar 

  43. Nakahara I, Taha MM, Higashi T, Iwamuro Y, Iwaasa M, Watanabe Y, et al. Different modalities of treatment of intracranial mycotic aneurysms: report of 4 cases. Surg Neurol. 2006;66(4):405–9. discussion 9–10

    PubMed  Google Scholar 

  44. Sundaram C, Goel D, Uppin SG, Seethajayalakshmi S, Borgohain R. Intracranial mycotic aneurysm due to Aspergillus species. J Clin Neurosci. 2007;14(9):882–6.

    CAS  PubMed  Google Scholar 

  45. Eddleman CS, Surdell D, DiPatri A Jr, Tomita T, Shaibani A. Infectious intracranial aneurysms in the pediatric population: endovascular treatment with Onyx. Childs Nerv Syst. 2008;24(8):909–15.

    PubMed  Google Scholar 

  46. Bhattacharyya A, Mittal S, Yadav RR, Jain K, Gupta B, Parihar A, et al. Endovascular management of infective intracranial aneurysms with acrylic glue. A report of two cases. Interv Neuroradiol. 2009;15(4):443–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  47. La Barge DV 3rd, Ng PP, Stevens EA, Friedline NK, Kestle JR, Schmidt RH. Extended intracranial applications for ethylene vinyl alcohol copolymer (Onyx): mycotic and dissecting aneurysms. Technical note. J Neurosurg. 2009;111(1):114–8.

    PubMed  Google Scholar 

  48. Fukuda W, Daitoku K, Minakawa M, Fukui K, Suzuki Y, Fukuda I. Infective endocarditis with cerebrovascular complications: timing of surgical intervention. Interact Cardiovasc Thorac Surg. 2012;14(1):26–30.

    PubMed  Google Scholar 

  49. Esenkaya A, Duzgun F, Cinar C, Bozkaya H, Eraslan C, Ozgiray E, et al. Endovascular treatment of intracranial infectious aneurysms. Neuroradiology. 2016;58(3):277–84.

    PubMed  Google Scholar 

  50. Matsubara N, Miyachi S, Izumi T, Yamanouchi T, Asai T, Ota K, et al. Results and current trends of multimodality treatment for infectious intracranial aneurysms. Neurol Med Chir. 2015;55(2):155–62.

    Google Scholar 

  51. Hui FK, Bain M, Obuchowski NA, Gordon S, Spiotta AM, Moskowitz S, et al. Mycotic aneurysm detection rates with cerebral angiography in patients with infective endocarditis. J Neurointerv Surg. 2015;7(6):449–52.

    PubMed  Google Scholar 

  52. Monteleone PP, Shrestha NK, Jacob J, Gordon SM, Fraser TG, Rehm SJ, et al. Clinical utility of cerebral angiography in the preoperative assessment of endocarditis. Vasc Med (London, England). 2014;19(6):500–6.

    Google Scholar 

  53. Jadhav AP, Pryor JC, Nogueira RG. Onyx embolization for the endovascular treatment of infectious and traumatic aneurysms involving the cranial and cerebral vasculature. J Neurointerv Surg. 2013;5(6):562–5.

    PubMed  Google Scholar 

  54. Allen LM, Fowler AM, Walker C, Derdeyn CP, Nguyen BV, Hasso AN, et al. Retrospective review of cerebral mycotic aneurysms in 26 patients: focus on treatment in strongly immunocompromised patients with a brief literature review. AJNR Am J Neuroradiol. 2013;34(4):823–7.

    CAS  PubMed  Google Scholar 

  55. Pruitt AA, Rubin RH, Karchmer AW, Duncan GW. Neurologic complications of bacterial endocarditis. Medicine. 1978;57(4):329–43.

    CAS  PubMed  Google Scholar 

  56. Frazee JG, Cahan LD, Winter J. Bacterial intracranial aneurysms. J Neurosurg. 1980;53(5):633–41.

    CAS  PubMed  Google Scholar 

  57. Monsuez JJ, Vittecoq D, Rosenbaum A, Goujon C, Wolff M, Witchitz S, et al. Prognosis of ruptured intracranial mycotic aneurysms: a review of 12 cases. Eur Heart J. 1989;10(9):821–5.

    CAS  PubMed  Google Scholar 

  58. Brust JC, Dickinson PC, Hughes JE, Holtzman RN. The diagnosis and treatment of cerebral mycotic aneurysms. Ann Neurol. 1990;27(3):238–46.

    CAS  PubMed  Google Scholar 

  59. Aspoas AR, de Villiers JC. Bacterial intracranial aneurysms. Br J Neurosurg. 1993;7(4):367–76.

    CAS  PubMed  Google Scholar 

  60. Yamada M, Miyasaka Y, Takagi H, Yada K. Cerebral bacterial aneurysm and indications for cerebral angiography in infective endocarditis. Neurol Med Chir. 1994;34(10):697–9.

    CAS  Google Scholar 

  61. Corr P, Wright M, Handler LC. Endocarditis-related cerebral aneurysms: radiologic changes with treatment. AJNR Am J Neuroradiol. 1995;16(4):745–8.

    CAS  PubMed  Google Scholar 

  62. Venkatesh SK, Phadke RV, Kalode RR, Kumar S, Jain VK. Intracranial infective aneurysms presenting with haemorrhage: an analysis of angiographic findings, management and outcome. Clin Radiol. 2000;55(12):946–53.

    CAS  PubMed  Google Scholar 

  63. Chun JY, Smith W, Halbach VV, Higashida RT, Wilson CB, Lawton MT. Current multimodality management of infectious intracranial aneurysms. Neurosurgery. 2001;48(6):1203–13. discussion 13–4.

    CAS  PubMed  Google Scholar 

  64. Phuong LK, Link M, Wijdicks E. Management of intracranial infectious aneurysms: a series of 16 cases. Neurosurgery. 2002;51(5):1145–51. discussion 51–2.

    PubMed  Google Scholar 

  65. Andreou A, Ioannidis I, Mitsos A. Endovascular treatment of peripheral intracranial aneurysms. AJNR Am J Neuroradiol. 2007;28(2):355–61.

    CAS  PubMed  Google Scholar 

  66. Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesavadas C, et al. Intracranial infectious aneurysm: presentation, management and outcome. J Neurol Sci. 2007;256(1–2):3–9.

    PubMed  Google Scholar 

  67. Dhomne S, Rao C, Shrivastava M, Sidhartha W, Limaye U. Endovascular management of ruptured cerebral mycotic aneurysms. Br J Neurosurg. 2008;22(1):46–52.

    CAS  PubMed  Google Scholar 

  68. Hetts SW, Narvid J, Sanai N, Lawton MT, Gupta N, Fullerton HJ, et al. Intracranial aneurysms in childhood: 27-year single-institution experience. AJNR Am J Neuroradiol. 2009;30(7):1315–24.

    CAS  PubMed  Google Scholar 

  69. Singla A, Fargen K, Blackburn S, Neal D, Martin TD, Hess PJ, et al. National treatment practices in the management of infectious intracranial aneurysms and infective endocarditis. J Neurointerv Surg. 2016;8(7):741–6.

    PubMed  Google Scholar 

  70. Petr O, Brinjikji W, Burrows AM, Cloft H, Kallmes DF, Lanzino G. Safety and efficacy of endovascular treatment for intracranial infectious aneurysms: a systematic review and meta-analysis. J Neuroradiol. 2016;43(5):309–16.

    PubMed  Google Scholar 

  71. Alawieh A, Chaudry MI, Turner RD, Turk AS, Spiotta AM. Infectious intracranial aneurysms: a systematic review of epidemiology, management, and outcomes. J Neurointerv Surg. 2018; Feb 20. pii: neurintsurg-2017-013603.

    Google Scholar 

  72. van der Meulen JH, Weststrate W, van Gijn J, Habbema JD. Is cerebral angiography indicated in infective endocarditis? Stroke. 1992;23(11):1662–7.

    PubMed  Google Scholar 

  73. Frizzell RT, Vitek JJ, Hill DL, Fisher WS 3rd. Treatment of a bacterial (mycotic) intracranial aneurysm using an endovascular approach. Neurosurgery. 1993;32(5):852–4.

    CAS  PubMed  Google Scholar 

  74. Kannoth S, Thomas SV. Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management. Neurocrit Care. 2009;11(1):120–9.

    PubMed  Google Scholar 

  75. Yoshioka D, Toda K, Sakaguchi T, Okazaki S, Yamauchi T, Miyagawa S, et al. Valve surgery in active endocarditis patients complicated by intracranial haemorrhage: the influence of the timing of surgery on neurological outcomes. Eur J Cardiothorac Surg. 2014;45(6):1082–8.

    PubMed  Google Scholar 

  76. Han MS, Jung SH, Kim TS, Joo SP. Reconstructive endovascular treatment of an intracranial infectious aneurysm in bacterial meningitis: a case report and review of literature. World Neurosurg. 2016;90:700.e1–5.

    Google Scholar 

  77. Clare CE, Barrow DL. Infectious intracranial aneurysms. Neurosurg Clin N Am. 1992;3(3):551–66.

    CAS  PubMed  Google Scholar 

  78. Modi G, Ranchod K, Modi M, Mochan A. Human immunodeficiency virus associated intracranial aneurysms: report of three adult patients with an overview of the literature. J Neurol Neurosurg Psychiatry. 2008;79(1):44–6.

    CAS  PubMed  Google Scholar 

  79. Bohmfalk GL, Story JL, Wissinger JP, Brown WE Jr. Bacterial intracranial aneurysm. J Neurosurg. 1978;48(3):369–82.

    CAS  PubMed  Google Scholar 

  80. Kojima Y, Saito A, Kim I. The role of serial angiography in the management of bacterial and fungal intracranial aneurysms – report of two cases and review of the literature. Neurol Med Chir. 1989;29(3):202–16.

    CAS  Google Scholar 

  81. Hung SC, Tai CT. Infective endocarditis complicated with thalamic infarction and mycotic aneurysm rupture: a case report. Zhonghua Yi Xue Za Zhi (Taipei). 1998;61(1):53–8.

    CAS  Google Scholar 

  82. Saito A, Kawaguchi T, Hori E, Kanamori M, Nishimura S, Sannohe S, et al. Subarachnoid hemorrhage after an ischemic attack due to a bacterial middle cerebral artery dissecting aneurysm: case report and literature review. Neurol Med Chir. 2014;54(3):196–200.

    Google Scholar 

  83. Kanai R, Shinoda J, Irie S, Inoue K, Sato T, Tsutsumi Y. A case of embolic stroke imitating atherothrombotic brain infarction before massive hemorrhage from an infectious aneurysm caused by streptococci. J Stroke Cerebrovasc Dis. 2012;21(8):910.e13–6.

    Google Scholar 

  84. Molinari GF, Smith L, Goldstein MN, Satran R. Pathogenesis of cerebral mycotic aneurysms. Neurology. 1973;23(4):325–32.

    CAS  PubMed  Google Scholar 

  85. Lotan E, Orion D, Bakon M, Kuperstein R, Greenberg G. Ruptured intracranial mycotic aneurysm in infective endocarditis: radiological and clinical findings. Isr Med Assoc J. 2014;16(5):317–9.

    PubMed  Google Scholar 

  86. Peters PJ, Harrison T, Lennox JL. A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis. 2006;6(11):742–8.

    PubMed  Google Scholar 

  87. Hage ZA, Naidech AM, Bendok BR. Diagnosing intracranial infectious aneurysms with a simple model. J Neurol Neurosurg Psychiatry. 2008;79(8):853.

    PubMed  Google Scholar 

  88. Ducruet AF, Hickman ZL, Zacharia BE, Narula R, Grobelny BT, Gorski J, et al. Intracranial infectious aneurysms: a comprehensive review. Neurosurg Rev. 2010;33(1):37–46.

    PubMed  Google Scholar 

  89. Walkoff L, Brinjikji W, Rouchaud A, Caroff J, Kallmes DF. Comparing magnetic resonance angiography (MRA) and computed tomography angiography (CTA) with conventional angiography in the detection of distal territory cerebral mycotic and oncotic aneurysms. Interv Neuroradiol. 2016;22(5):524–8.

    PubMed  PubMed Central  Google Scholar 

  90. Rogers AC, Bourke M, Galbraith AS, Ryan AG, Cross KS, McMonagle MP. Mycotic aneurysm of the extracranial internal carotid artery, resect and ligate or reconstruct? Ann Vasc Surg. 2016;35:203.e5–e10.

    Google Scholar 

  91. Utoh J, Miyauchi Y, Goto H, Obayashi H, Hirata T. Endovascular approach for an intracranial mycotic aneurysm associated with infective endocarditis. J Thorac Cardiovasc Surg. 1995;110(2):557–9.

    CAS  PubMed  Google Scholar 

  92. Miura T, Eishi K. Current treatment of active infective endocarditis with brain complications. Gen Thorac Cardiovasc Surg. 2013;61(10):551–9.

    PubMed  Google Scholar 

  93. Voiriot P, Dureux JB. Cerebral mycotic aneurysms. Epidemiology, symptomatic aspects and prognosis. Ann Med Interne. 1989;140(2):118–21.

    CAS  Google Scholar 

  94. Pavic M, Debourdeau P, Teixeira L, Brunot J, Colle B, Flechaire A. Bacterial cerebral aneurysms without infectious endocarditis: analysis of a case and review of the literature. Rev Med Interne. 2001;22(9):867–71.

    CAS  PubMed  Google Scholar 

  95. Fukuda W, Daitoku K, Minakawa M, Suzuki Y, Fukuda I. Management of infective endocarditis with neurological complication. Kyobu Geka. 2015;68(11):896–902.

    PubMed  Google Scholar 

  96. Carvalho FG, Godoy BL, Reis M, Gasparetto EL, Wajnberg E, de Souza JM. Frameless stereotactic navigation for intraoperative localization of infectious intracranial aneurysm. Arq Neuropsiquiatr. 2009;67(3B):911–3.

    PubMed  Google Scholar 

  97. Elowiz EH, Johnson WD, Milhorat TH. Computerized tomography (CT) localized stereotactic craniotomy for excision of a bacterial intracranial aneurysm. Surg Neurol. 1995;44(3):265–9.

    CAS  PubMed  Google Scholar 

  98. D’Angelo V, Fiumara E, Gorgoglione L, Florio F, Ceddia A. Surgical treatment of a cerebral mycotic aneurysm using the stereo-angiographic localizer. Surg Neurol. 1995;44(3):263–4.

    PubMed  Google Scholar 

Download references

Acknowledgments

Authors acknowledge support from the American Heart Association to A.A. (15PRE25250009).

Author information

Authors and Affiliations

  1. Medical Scientist Training Program, Medical University of South Carolina, Charleston, SC, USA

    Ali Alawieh

  2. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Alejandro M. Spiotta

Authors
  1. Ali Alawieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alejandro M. Spiotta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alejandro M. Spiotta .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Alejandro M. Spiotta

  2. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Raymond D. Turner

  3. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    M. Imran Chaudry

  4. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Aquilla S. Turk

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alawieh, A., Spiotta, A.M. (2019). Infectious Intracranial Aneurysms: Epidemiology, Pathophysiology, and Management. In: Spiotta, A., Turner, R., Chaudry, M., Turk, A. (eds) Management of Cerebrovascular Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-99016-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99016-3_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99015-6

  • Online ISBN: 978-3-319-99016-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation