Abstract
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.
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Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg 1995;110(6):1745–1755.
Erdogan, HB, Erentug V, Bozbuga N, Goksedef D, Akinci E, Yakut C. Endovascular treatment of intracerebral mycotic aneurysm. Tex Heart Inst J 2004;31:165–167.
Peters P, Harison T, Lennox JL. A dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis 2006;6:742–748.
Watanabe A, Hirano K, Ishii R. Cerebral mycotic aneurysm treated with endovascular occlusion: case report. Neurol Med Chir (Tokyo) 1998;38:657–660.
Yamaguchi H, Eishi K. Surgical treatment of active infective mitral valve endocarditis. Ann Thorac Cardiovasc Surg 2007;13(3):150–155.
Gillinov AM, Shah R, Curtis WE, Stuart S, Cameron DE, Baumgartner WA, Greene PS. Valve replacement in patients with endocarditis and acute neurologic deficit. Ann Thorac Surg 1996;61:1125–1130.
Fujii Y, Fukuda I, Kigawa I, Yamabuki K, Noguchi Y. Mitral valve replacement secondary to presection of mycotic cerebral aneurysm in acute phase of bacterial endocarditis: a case report. Nihon Kyobu Geka Gakkaishi 1994;42:1231–1234.
Kuki S, Yoshida K, Suzuki R, Matsumura R, Okuda A. Successful surgical management for multiple cerebral mycotic aneurysms involving both carotid and vertebrabasilar systems in active infective endocarditis. Eur J Cardiothorac Surg 1994;8:508–510.
Minakata K, Konishi Y, Matsumoto M, Miwa S. Surgical treatment of infective endocarditis associated with cerebral mycotic aneurysm. Kyobu Geka 1997;50:7:544–548.
Tsutsumida H, Nakamura K, Matsuzaki Y, Onitsuka T. A case of heart operation in infective endocarditis after brain surgery for mycotic cerebral aneurysm. Kyobu Geka 2000;53:3:229–231.
Asai T, Usui A, Miyachi S, Ueda Y. Endovascular treatment for intracranial mycotic aneurysms prior to cardiac surgery. Eur J Cardiothorac Surg 2002;21:948–950.
Taguchi S, Takakura H, Hachiya T, Onoguchi K, Sasaki T, Hashimoto K. Infective endocarditis associated with multiple mycotic aneurysm: report of a case. Kyobu Geka 2006;59:3:229–233.
Sugiki H, Shiiya N, Murashita T, Kubota T, Yasuda K. Infectious endocarditis complicated with preoperative cerebral infarction and rupture of infectious intracranial aneurysm. Kyobu Geka 2006;59:1:65–69
Yunoki T, Minakata K. A surgical case of infective endocarditis presenting with intracranial hemorrhage due to ruptured cerebral mycotic aneurysm. Jpn J Cardiovasc Surg 2008:37:21–24.
Guidelines for the prevention and treatment of infective endocarditis (JCS 2003). Circ J 2003;67:suppl IV.
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Fujita, W., Daitoku, K., Taniguchi, S. et al. Infective endocarditis with cerebral mycotic aneurysm: treatment dilemma. Gen Thorac Cardiovasc Surg 58, 622–625 (2010). https://doi.org/10.1007/s11748-009-0581-3
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DOI: https://doi.org/10.1007/s11748-009-0581-3