Title

Intracranial infectious aneurysms: a comprehensive review

Document Type

Article

Abstract

Intracranial infectious aneurysms, or mycotic aneurysms, are rare infectious cerebrovascular lesions which arise through microbial infection of the cerebral arterial wall. Due to the rarity of these lesions, the variability in their clinical presentations, and the lack of population-based epidemiological data, there is no widely accepted management methodology. We undertook a comprehensive literature search using the OVID gateway of the MEDLINE database (1950-2009) using the following keywords (singly and in combination): "infectious," "mycotic," "cerebral aneurysm," and "intracranial aneurysm." We identified 27 published clinical series describing a total of 287 patients in the English literature that presented demographic and clinical data regarding presentation, treatment, and outcome of patients with mycotic aneurysms. We then synthesized the available data into a combined cohort to more closely estimate the true demographic and clinical characteristics of this disease. We follow by presenting a comprehensive review of mycotic aneurysms, highlighting current treatment paradigms. The literature supports the administration of antibiotics in conjunction with surgical or endovascular intervention depending on the character and location of the aneurysm, as well as the clinical status of the patient. Mycotic aneurysms comprise an important subtype of potentially life-threatening cerebrovascular lesions, and further prospective studies are warranted to define outcome following both conservative and surgical or endovascular treatment.

Medical Subject Headings

Aneurysm, Infected (diagnosis, epidemiology, microbiology, pathology, surgery); Aneurysm, Ruptured (surgery); Humans; Intracranial Aneurysm (diagnosis, epidemiology, microbiology, pathology, surgery); Neurosurgical Procedures; Treatment Outcome

Publication Date

1-1-2010

Publication Title

Neurosurgical review

E-ISSN

1437-2320

Volume

33

Issue

1

First Page

37

Last Page

46

PubMed ID

19838745

Digital Object Identifier (DOI)

10.1007/s10143-009-0233-1

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