Case report

https://doi.org/10.20471/acc.2020.59.04.24

Current Endovascular Management of Infected Distal Branch Intracranial Aneurysms: a Case Report and Insight into the Literature

Vladimir Kalousek ; Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Tomislav Sajko ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Bruno Splavski ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia
Krešimir Rotim ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
Mia Jurilj ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Branimir Čulo ; Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ante Rotim ; Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia

Abstract

Infected intracranial aneurysms are a rare type of inflammatory vascular lesions
that occur due to infection of intracranial arterial wall. Brain aneurysms of distal arterial branches are
equally rare and frequently multiple, including those situated at the peripheral middle cerebral artery
segments. Although both types represent a small percentage of all intracranial aneurysms, they may
bring about high mortality in case of rupture. The management of such aneurysms includes conservative
treatment with broad-spectrum antibiotics, and microsurgical or endovascular treatment, which is
gaining more prominence for both asymptomatic and ruptured aneurysms. Herein, we present a case
of a 61-year-old male patient with a history of cardiac infective disease and multiple bilateral aneurysms
of infected distal branch middle cerebral arteries, discussing the efficacy of available endovascular
treatment modalities and reviewing the literature. In conclusion, selective endovascular coiling is a
preferable method in the current management of distal branch infected ruptured intracranial aneurysms,
which may bring a favorable outcome.

Keywords

Infected intracranial multiple aneurysms; Distal cerebral arterial branches; Aneurysmal rupture; Treatment modalities; Endovascular coiling; Outcome

Hrčak ID:

255232

URI

https://hrcak.srce.hr/255232

Publication date:

1.12.2020.

Article data in other languages: croatian

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